糖尿病性黄斑水肿(DME)从阿非利西普过渡到生物类似药雷尼单抗:(TRANSFORM-DME试验)一项多中心观察研究。

Clinical ophthalmology (Auckland, N.Z.) Pub Date : 2024-11-25 eCollection Date: 2024-01-01 DOI:10.2147/OPTH.S500912
Debdulal Chakraborty, Tushar Kanti Sinha, Aniruddha Maiti, Subhendu Kumar Boral, Arnab Das, Soumen Mondal, Krishnendu Nandi, Ranabir Bhattacharya
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引用次数: 0

摘要

目的:评估糖尿病黄斑水肿(DME)患者从玻璃体内注射afliberept (IVI AFL) (T1)切换到生物仿制药Ranibizumab (B-RBZ) (T2)后的视觉和解剖学结果。方法:这是一项多中心观察性研究,分析了连续treatment-naïve中心的DME患者的医疗记录,这些患者的基线视力(VA)≥55早期治疗糖尿病视网膜病变研究(ETDRS)字母。确定了每月接受IVI AFL负荷剂量(T1)并对其有反应的DME患者,他们随后由于经济限制而不是对IVI AFL缺乏疗效而转向B-RBZ(T2)。结果:本研究纳入57例患者(平均年龄:54.23±6.91岁),其中80.7%为男性。在T1期间,VA得到改善,从基线时的61.4±11.74个ETDRS字母到72.7±8.05个ETDRS字母(平均变化:+11.2个字母,95% CI: 9.1 ~ 13.4;P < 0.001)。在T2期间,VA在12个月内略有下降,12个月时平均VA为69.9±3.78个ETDRS字母(比基线增加8.5个字母;P < 0.001)。T1期间平均黄斑中央厚度(CMT)由基线时的411.9±34.62 μm降至279.3±9.96 μm(平均变化:-132.6 μm, 95% CI: -142.2 ~ -122.9 μm;P < 0.001)。CMT在12个月的随访期间保持稳定,波动最小。视网膜下液(SRF)和视网膜内液(IRF)分别在84.2%和91.2%的眼睛中存在,切换时分别下降到5.3%和7.0% (p < 0.001)。在T2期,研究结束时SRF和IRF分别为22.8%和21.1%。结论:DME患者在接受阿非利塞普初始治疗后改用生物仿制药雷尼单抗(Razumab),在12个月的时间内保持了视觉和解剖学上的益处,SRF和IRF只有微小的变化。这些结果强调了生物仿制药雷尼单抗作为治疗二甲醚的成本效益选择的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transitioning from Aflibercept to Biosimilar Ranibizumab in Diabetic Macular Edema (DME): (The TRANSFORM-DME Trial) a Multicenter Observational Study.

Purpose: To evaluate visual and anatomical outcomes following a switch from intravitreal Aflibercept (IVI AFL) (T1) to biosimilar Ranibizumab (B-RBZ) (T2) in patients with diabetic macular edema (DME).

Methods: This was a multicenter observational study, analysing medical records of consecutive, treatment-naïve centre-involving DME patients having a baseline visual acuity (VA) of ≥55 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. DME patients, having received monthly loading doses of IVI AFL(T1) and responsive to it, who subsequently shifted to B-RBZ(T2) motivated by financial constraints rather than a lack of efficacy to IVI AFL were identified.

Results: This study included 57 participants (mean age: 54.23 ± 6.91 years), with 80.7% male patients. VA improved during T1, from 61.4 ± 11.74 ETDRS letters at baseline to 72.7 ± 8.05 ETDRS letters (mean change: +11.2 letters, 95% CI: 9.1 to 13.4; p < 0.001). During T2, VA declined slightly over 12 months with a mean VA of 69.9 ± 3.78 ETDRS letters at the 12-month mark (+8.5 letters from baseline; p < 0.001). Mean central macular thickness (CMT) during T1 reduced from 411.9 ± 34.62 μm at baseline to 279.3 ± 9.96 μm (mean change: -132.6 μm, 95% CI: -142.2 to -122.9 μm; p < 0.001). CMT remained stable over the 12-month follow-up period, with minimal fluctuations. Subretinal fluid (SRF) and intra retinal fluid (IRF) were present in 84.2% and 91.2% of eyes, respectively, decreasing to 5.3% and 7.0% at the time of switch (p < 0.001). In T2 phase, 22.8% and 21.1% exhibited SRF and IRF, respectively, at the end of the study.

Conclusion: Transitioning to biosimilar Ranibizumab (Razumab) after initial treatment with aflibercept in patients with DME preserved visual and anatomical benefits over a 12-month period, with only minor variations in SRF and IRF. These results underscore the efficacy of biosimilar Ranibizumab as a cost-effective option for managing DME.

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