The da VINCI study: Phase 2 primary results of VEGF trap-eye in patients with diabetic macular edema

Diana V. Do, Ursula Schmidt-Erfurth, Victor H. Gonzalez, Carmelina M. Gordon, Michael Tolentino, Alyson J. Berliner, Robert Vitti, Rene Rückert, Rupert Sandbrink, David Stein, Ke Yang, Karola Beckmann, Jeff S. Heier

Research output: Contribution to journalArticlepeer-review

195 Scopus citations

Abstract

Purpose: To determine whether different doses and dosing regimens of intravitreal vascular endothelial growth factor (VEGF) Trap-Eye are superior to focal/grid photocoagulation in eyes with diabetic macular edema (DME). Design: Multicenter, randomized, double-masked, phase 2 clinical trial. Participants: A total of 221 diabetic patients with clinically significant macular edema involving the central macula. Methods: Patients were assigned to 1 of 5 treatment regimens: 0.5 mg VEGF Trap-Eye every 4 weeks; 2 mg VEGF Trap-Eye every 4 weeks; 2 mg VEGF Trap-Eye for 3 initial monthly doses and then every 8 weeks; 2 mg VEGF Trap-Eye for 3 initial monthly doses and then on an as-needed (PRN) basis; or macular laser photocoagulation. Assessments were completed at baseline and every 4 weeks thereafter. Main Outcome Measures: Mean change in visual acuity and central retinal thickness (CRT) at 24 weeks. Results: Patients in the 4 VEGF Trap-Eye groups experienced mean visual acuity benefits ranging from +8.5 to +11.4 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters versus only +2.5 letters in the laser group (P ≤ 0.0085 for each VEGF Trap-Eye group vs. laser). Gains from baseline of 0+, 10+, and 15+ letters were seen in up to 93%, 64%, and 34% of VEGF Trap-Eye groups versus up to 68%, 32%, and 21% in the laser group, respectively. Mean reductions in CRT in the 4 VEGF Trap-Eye groups ranged from -127.3 to -194.5 μm compared with only -67.9 μm in the laser group (P = 0.0066 for each VEGF Trap-Eye group vs. laser). VEGF Trap-Eye was generally well tolerated. Ocular adverse events in patients treated with VEGF Trap-Eye were generally consistent with those seen with other intravitreal anti-VEGF agents. Conclusions: Intravitreal VEGF Trap-Eye produced a statistically significant and clinically relevant improvement in visual acuity when compared with macular laser photocoagulation in patients with DME. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Original languageEnglish (US)
Pages (from-to)1819-1826
Number of pages8
JournalOphthalmology
Volume118
Issue number9
DOIs
StatePublished - Sep 2011
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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