Aflibercept delivers for diabetic macular oedema in real-world study

Real-world data show that aflibercept effectively improves visual acuity (VA) outcomes in patients with diabetic macular oedema (DME). However, factors such as age, baseline VA, and deprivation may affect the effectivity of aflibercept.

The study included retrospectively collected anonymised data from 1,742 DME patients who were given aflibercept over 3 years. Comparisons were conducted to determine potential correlates of 12-month VA change, including the following factors: age, baseline letter score, number of injections, and deprivation, as measured by the index of multiple deprivation score (IMD).

Study participants sought care from more than 20 centres across the UK. The researchers detected significant heterogeneity among centres in terms of baseline age (p<0.0001), IMD score (p<0.0001), and VA (p<0.0001). Death rates ranged from 0 percent to 7.5 percent across centres.

Mean VA at baseline was 62 letters, which improved by a median of 5 letters after 6 injections. Patients with worse baseline VA saw significantly greater improvements (p<0.001). Those with <50 letters at baseline improved by 13.9 letters, while those with ≥80 letters saw a decrease of 3.2 letters.

Age was also an important factor, with older patients reporting significantly smaller VA improvements (p=0.0002). Those who were >75 years, for instance, only gained 4.2 letters, as opposed to patients <55 years of age, whose VA improved by 6.6 letters.

In contrast, IMD was not significantly correlated with the change in VA. However, patients who were most deprived tended to be younger (p=0.0017), had worse VA at first injection (p=0.0001), and were more likely to be lost to follow-up (p=0.001). Hence, deprived participants started from worse baseline VA, were less likely to complete the intervention, and tended to have worse vision at 1-year (p=0.0001).