The Latest on Eylea: A Leading Treatment for Diabetes-Related Retinopathy

New results from Eylea, a treatment for diabetes-related retinopathy, show that when used for prevention, treatment reduces the risk of more severe ocular complications.

The major findings were recently published in Eylea, a common US therapy used to treat several eye diseases, including diabetes-related eye diseases. According to Dr. Jennifer Sun, co-chair of the Diabetic Retinopathy Clinical Research Network, 60% of patients may not know that they have an early stage diabetes-related retinopathy form that may not affect their ability to see. The clinical trials focused on prevention. Will early EYLEA treatment for diabetes-related retinopathy lead to better vision later? The answer may not be clear yet – Eylea was found to reduce certain vision-threatening complications, but published studies did not significantly improve visual acuity results.

EYLEA is an approved treatment for diabetes-related macular edema and diabetes-related retinopathy for two ocular complications associated with two ocular complications associated with diabetes. EYLEA is an anti-VEGF therapy. In other words, the drug blocks VEGF, a protein necessary for the growth of new blood vessels. Depending on the severity of the eye disease, medication is injected into the eye by the ophthalmologist every 4-16 weeks.

The study examined 328 adults with early stage diabetes-related retinopathy (also known as non-nutrient diabetes-related retinopathy) and excellent vision. At the start of the study, approximately half of the eyes received an Eylea injection every 16 weeks, and the other half received a placebo injection (including drugs). Preliminary data were reported over two years. This study lasts for a total of four years.

The researchers were studying two key findings with these eyes.

• Changes in the anatomy of the retinal (because of evidence of a higher stage of diabetes-associated retinopathy, known as proliferative diabetes-associated retinopathy, or evidence of the development of swelling called diabetic-associated macular edema, dissolved in the center). These can be considered structural changes of the eye.
• Functional differences in participants’ abilities known as vision. See below for important findings in two years.

The trials found that EYLEA led to improved anatomical outcomes and reduced the risk of more severe ocular complications.

• EYLEA reduced the risk of complications by 68% compared to placebo. The probability of developing complications was 16% in the EYLEA group and 44% in the placebo group.
• Individually, participants taking EYLEA are 66% less likely to develop a more advanced stage of diabetes-associated retinopathy (proliferative diabetes-associated retinopathy) and 64% less likely to develop macular edema with vision loss.
• Those who received a placebo injection were five times more likely to require additional treatment (using EYLEA) with an aggravation of their eye disease.
• Two years later, there was no difference in visual acuity quality in either group (75% of the treatment group and 72% of the placebo group).

The results of the four-year trial are important in determining whether a high percentage of complications in the placebo group ultimately lead to vision loss in that group. In this case, treating diabetes and retinopathy at the earliest stage with EYLEA can have long-term benefits for vision.

There are several treatment options for diabetes-related eye diseases, including oral medications, eye laser treatments, and treatments like Eylea. More and more surgical techniques are being used in the advanced stages of diabetes-related eye diseases. Other new strategies have also been investigated to avoid the need for regular injections into the eye.

More information is needed before using Eylea as a broad tool to prevent worsening diabetes-related retinopathy. Dr. Sun’s final benefits for clinicians and patients? “The possibility of maintaining good vision even with severe non-nutrient diabetic retinopathy and moderate non-nutrient diabetic retinopathy due to regular follow-up and rigorous evaluation is great. This study should still give early treatment regularly.

The most important behavior that people with diabetes can take is to have an expanded eye test annually, in addition to managing glucose, blood pressure and cholesterol levels. As diabetes-related eye diseases worsen, there are many options that can be used to prevent vision loss. For more information on eye protection and treatment of eye diseases, check out the series: Care for your eye.