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    Dexamethasone for DME shows stronger results compared with sham group

    Subgroups defined by demographics, diabetes status, duration of disease and prior treatment

    Take-home message: In this article Dr Anat Lowenstein explains that the benefits of treatment with a dexamethasone intravitreal implant for DME were observed across a variety of demographic characteristics.

     

    The benefits of treatment with a dexamethasone intravitreal implant (Ozurdex, Allergan, Irvine, CA, USA) for diabetic macular edema (DME) were found in a variety of subgroups. These groups were defined by demographics, diabetes status, diabetes and DME duration, prior treatment, and severity of diabetes, according to Dr Anat Lowenstein, Sourasky Medical Center, Tel Aviv, Israel.

    Study details

    Dr Lowenstein presented the results of a subgroup analysis of the MEAD trial, focused on 3-year results with the dexamethasone implant 0.7 and 0.35 mg in 1,048 patients with DME.

    The trial met its primary efficacy endpoint of improvement in best-corrected visual acuity (BCVA) stronger than that of the sham-controlled group and had a safety profile consistent with previous reports, according to study authors.1

    Dr Lowenstein described a typical patient from the trial. The patient was a 65-year-old with severe diabetic retinopathy in both eyes. Despite focal laser therapy and three bevacizumab injections, the patient still had severe DME. The patient was treated with the dexamethasone implant, responded nicely for 4 to 5 months, and then had another recurrence. The patient developed a cataract and was treated for it after the third use of the implant. 

    “At the last follow-up, with the seventh injection, the patient had good anatomic results,” Dr Lowenstein said.

    Dr Lowenstein also described the various parameters under which the implant performed better than the sham-controlled group, including mean change in BCVA from baseline at 3 years, a BCVA improvement of 15 letters or more at 3 years, the time that it took to reach an improvement of 15 letters or more and the mean average change from baseline in ocular coherence tomography retinal thickness at the centre subfield. The numbers were clinically higher in patients in the 0.35mg group as well as the 0.7mg group. 

    Subgroup analysis

    The improvements with the implant also spanned a variety of demographic characteristics.

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