We recently reported on new guidance from NICE about the treatment of diabetic macular oedema with ranibizumab. Another systematic review recently looked at another injectable drug with a similar role: bevacizumab, or Avastin.
In patients with diabetic macular oedema (DMO), does intravitral injection of bevacizumab (IVB) improve visual acuity?
The review focused on previously untreated cases of DMO rather than those that had been previously unsuccessfully treated.
Four randomised trials were found that met compared IVB with laser treatment (macular photocoagulation). Three compared IVB with the combined treatment of IVB and intravitral triamcinolone acetonide injection.
Both comparisons found a significant benefit for IVB at six weeks, but not at 12 weeks.
- What was the methodological quaility of the individual trials?
- How were the visual acuity outcomes measured? Were they consistent between studies?
- Note that visual acuity improved at 6 weeks but this improvement was not maintained at 12 weeks.
Yilmaz T, Cordero-Coma M, Gallagher MJ, Teasley LA. Systematic review of intravitreal bevacizumab injection for treatment of primary diabetic macular oedema. Acta Ophthalmol. 2011 Dec;89(8):709-17.