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Findings from Two Studies on Diabetic Eye Disease Treatment Released
ACCORD Eye Study Finds Two Therapies May Slow Progression of Diabetic Eye Disease
A photo of an eye with diabetic macular edema.
Photo courtesy of the National Eye Institute,
National Institutes of Health.A clinical trial of people with type 2 diabetes showed that intensively controlling blood glucose to near-normal levels reduced progression of diabetic retinopathy, the leading cause of vision loss in working-age Americans. Adding a fibrate drug to statin therapy for control of blood lipids also reduced disease progression. These results come from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study, a subgroup study of the ACCORD clinical trial supported by the National Eye Institute (NEI). The National Heart, Lung, and Blood Institute is the primary sponsor of ACCORD.
ACCORD compared the effect of intensive control of blood glucose, blood pressure, and blood lipids with standard, less-intensive treatments on the risk of major cardiovascular disease events in more than 10,000 adults with established type 2 diabetes. While the earlier ACCORD finding of increased mortality risk outweighed the benefits of near-normal control in the group studied, the ACCORD Eye Study and other recent ACCORD findings suggest there may be benefits to controlling blood glucose to targets lower than currently recommended in patients in whom such control can be achieved safely—for example, in people recently diagnosed with diabetes.
“The ACCORD Eye Study clearly indicates that intensive glycemic control and fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy,” said Emily Chew, M.D., chair of the Eye Study and chief of the Clinical Trials Branch of the Division of Epidemiology and Clinical Applications at the NEI.
The study findings were published in the July 15, 2010, issue of The New England Journal of Medicine. More information about the ACCORD Eye Study can be found at www.nei.nih.gov/news/pressreleases/062910.asp.
Combination of Ranibizumab and Laser Therapy Proves Effective in Treating Diabetic Macular Edema
Researchers have found that the drug ranibizumab (Lucentis), combined with the current standard treatment of laser therapy, is more effective than laser therapy alone in treating diabetic macular edema (DME), a major complication of diabetes that can result in vision loss. DME occurs when fluid from damaged blood vessels in the eye cause swelling of the macula, part of the retina. Ranibizumab blocks the leakage of fluid from the blood vessels. Results of this study were published in the June 2010 issue of Ophthalmology.
This study provides the first definitive proof that a combined treatment and follow-up strategy could halt and reverse diabetic eye disease. “This comparative-effectiveness study demonstrated that a new treatment can protect and, in many cases, improve the vision of people with diabetic macular edema,” said Paul A. Sieving, M.D., Ph.D., director of the NEI.
The 2-year study focused on the effectiveness of three DME treatments: laser treatment alone; ranibizumab plus laser treatment; and the steroid drug triamcinolone (Trivaris) plus laser treatment. Specifically, the researchers found that ranibizumab combined with laser treatment improved vision significantly, compared with laser treatment alone.
The multicenter clinical trial was conducted by the NEI and the Diabetic Retinopathy Clinical Research Network (DRCR.net). DRCR.net researchers will continue to monitor the study participants for at least 3 years to gather more data about the safety and effectiveness of the treatments.
For more information about this study, see www.nih.gov/researchmatters/may2010/ 05102010eye.htm or visit www.drcr.net.
The National Institute of Diabetes and Digestive and Kidney Diseases has easy-to-read booklets and fact sheets about diabetes and its complications, including diabetic eye disease. For more information or to obtain copies, visit www.diabetes.niddk.nih.gov.
NIH Publication No. 11–4562
Page last updated: December 5, 2011