Assessment of Anti-VEGFs in Treating Diabetic Macular Edema in Alfaisal Eye Center, Khartoum, Sudan, 2019

IF 3.1 Q2 PHARMACOLOGY & PHARMACY
Rayan Hamza Mohammed Ahmedalgabri, Tarig Omer, Fatima Zarroug, Abdullah Omer Elkhawad, M. Noma
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引用次数: 0

Abstract

Background Anti-vascular endothelial growth factor (anti-VEGF) medicines have revolutionized DME and DR treatment. Despite the worldwide use of anti-VEGFs, their use remains limited in Sudan. This study aimed to assess the impact of anti-VEGF (ranibizumab and bevacizumab) injections in patients with diabetic macular oedema in Khartoum, Sudan. Methods An analytical comparative cross-sectional study was implemented in Alfaisal referral eye centre. A Standard questionnaire was used to collect the variables related to the research objectives. Thirty-four patients were recruited; 16 patients under ranibizumab (Lucentis) and 18 under bevacizumab (Avastin). Data were analyzed through SPSS 23, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measurements were considered as main outcomes to evaluate the treatment effectiveness. Results Among the 34 participants, 64.7% were males and 35.3% were females, with an average age of 62 years and 13 years of long standing diabetes. A total of 54 eyes received an average of 2.3 injections in an average of 7 months’ period. The mean BCVA before and after treatment for both drugs respectively 0.19 min and 0.21 min was statistically correlated (p = 0.000). For patients under Lucentis, the mean BCVA before and after medication was 0.20 min–0.24 min and 0.19–0.19 min for those who used Avastin. The mean central retinal thickness (CRT), before and after treatment for both drugs, was 492.22µm–422.89µm, respectively, with a significant correlation (p = 0.003). For patients under Lucentis, the mean CRT decreased from 536.30 µm to 425.19 µm; it dropped from 453.16µm to 421.18µm for patients under Avastin. About 79.4% (27/34) of the participants reported that injections were not affordable and 14.7% (5/34) complained from shortage of one dose, regardless of which type of treatment. Glycaemia control, duration of treatment, type and frequency of injections used were found to be the most contributing factors to the effectiveness of anti-VEGF medications. Conclusion Both anti-VEGF medications are effective in treating DME, Lucentis showed better improvements in BCVA and macular thickness than Avastin. Policymakers in Sudan require urgent alternative strategies to increase access to these medications.
2019年,苏丹喀土穆Alfaisal眼科中心抗VEGFs治疗糖尿病黄斑水肿的评估
背景抗血管内皮生长因子(Anti-VEGF)药物已经彻底改变了DME和DR的治疗。尽管全世界都在使用抗VEGF,但它们在苏丹的使用仍然有限。本研究旨在评估抗VEGF(雷尼珠单抗和贝伐单抗)注射对苏丹喀土穆糖尿病黄斑水肿患者的影响。方法在Alfaisal转诊眼科中心进行横断面分析比较研究。使用标准问卷来收集与研究目标相关的变量。招募了34名患者;接受雷尼珠单抗(Lucentis)治疗的16名患者和接受贝伐单抗(Avastin)治疗的18名患者。数据通过SPSS 23进行分析,最佳矫正视力(BCVA)和中央视网膜厚度(CRT)测量被认为是评估治疗效果的主要结果。结果34名参与者中,男性占64.7%,女性占35.3%,平均年龄62岁,长期糖尿病13岁。共有54只眼睛在平均7个月的时间内接受了平均2.3次注射。两种药物治疗前和治疗后的平均BCVA分别为0.19分钟和0.21分钟,具有统计学相关性(p=0.000)。对于Lucentis患者,使用阿瓦斯汀的患者,用药前和用药后的平均BC VA分别为0.20分钟–0.24分钟和0.19分钟–0.19分钟。两种药物治疗前后的平均中央视网膜厚度(CRT)分别为492.22µm–422.89µm,具有显著相关性(p=0.003)。对于Lucentis患者,平均CRT从536.30µm降至425.19µm;Avastin治疗的患者,其从453.16µm降至421.18µm。约79.4%(27/34)的参与者报告说,无论哪种治疗类型,注射都负担不起,14.7%(5/34)的参与者抱怨一剂疫苗短缺。发现血糖控制、治疗持续时间、注射类型和频率是影响抗VEGF药物有效性的最大因素。结论两种抗VEGF药物均能有效治疗DME,Lucentis对BCVA和黄斑厚度的改善效果优于Avastin。苏丹的政策制定者需要紧急的替代策略来增加获得这些药物的机会。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
14
审稿时长
16 weeks
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