Abstract
PURPOSE. To compare blood pressure and urine albumin-creatinine ratio over time for participants receiving aflibercept, bevacizumab, or ranibizumab. METHODS. Preplanned secondary analyses from a randomized trial comparing aflibercept, bevacizumab, and ranibizumab for diabetic macular edema (DME). The Diabetic Retinopathy Clinical Research Network (DRCR.net) enrolled 660 participants with DME and visual acuity 20/32 or worse in at least one eye. Eyes received intravitreous injections of 2.0 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab based on a structured retreatment protocol over 2 years. Main outcome measures were (1) a change in blood pressure at 2 years, and (2) a change in urine albumin-creatinine ratio (UACR) at 1 year. RESULTS. At baseline, 95 participants (14%) had normal blood pressure, 220 (33%) had borderline blood pressure elevation, 206 (31%) had mild blood pressure elevation, and 139 (21%) had moderate blood pressure elevation. Average change in mean arterial pressure from baseline to 2 years was 1.2 ± 15, 1.8 ± 13.5, 2.6 ± 14.4 mm Hg in the aflibercept, bevacizumab, and ranibizumab groups, respectively (global P = 0.69). At baseline 247 participants (38%) had no albuminuria (<30 mg/g), 195 (30%) had microalbuminuria (30–300 mg/g), and 212 (32%) had macroalbuminuria (>300 mg/g). Changes in UACR category were not different among treatment groups at the 52-week visit (global P = 0.29). CONCLUSIONS. There do not appear to be treatment group differences for changes in blood pressure or UACR as a reflection of kidney function in patients with DME treated with aflibercept, bevacizumab, or ranibizumab.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1199-1205 |
| Number of pages | 7 |
| Journal | Investigative Ophthalmology and Visual Science |
| Volume | 59 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2018 |
Funding
Supported by a cooperative agreement from the National Eye Institute and the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (EY14231, EY23207, and EY18817). Regeneron Pharmaceutical (Tarrytown, NY, USA) provided the aflibercept and Genentech provided the ranibizumab for the study. Genentech (San Francisco, CA, USA) also provided funding for the plasma collection from this ancillary study. As per the DRCR.net Industry Collaboration Guidelines (available at www.drcr.net), the DRCR.net had complete control over the design of the protocol, ownership of the data, and all editorial content of presentations and publications related to the protocol. The funding organization (National Institutes of Health) participated in oversight of the conduct of the study and review of the manuscript but not directly in the conduct of the study, nor in the collection, management, or analysis of the data. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A complete list of all DRCR.net investigator financial disclosures can be found at www.drcr.net. Disclosure: A.R. Glassman, None; D. Liu, None; L.M. Jampol, None; J.K. Sun, Merck (C), Novartis (C), Genentech (R)
Keywords
- Anti-VEGF
- Blood pressure
- Diabetic macular edema
- UACR
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience
- Ophthalmology
