Topical bromfenac as adjunctive treatment with intravitreal ranibizumab for diabetic macular edema

Gabr, Ahmed Fathy; Kamel, Marian Faried; Elbarawy, Ahmed A

doi:10.1007/s10792-023-02722-1

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Certain ophthalmic-specific NSAIDs have proven to be effective in mitigating macular edema and enhancing vision. Notable examples include ketorolac, a potent COX-1 inhibitor, and bromfenac, a potent COX-2 inhibitor [149][150][151][152].…”

Section: Anti-inflammatory Drugsmentioning

confidence: 99%

Diabetic Retinopathy: New Treatment Approaches Targeting Redox and Immune Mechanisms

Tang,

Buonfiglio,

Böhm

et al. 2024

Antioxidants

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Diabetic retinopathy (DR) represents a severe complication of diabetes mellitus, characterized by irreversible visual impairment resulting from microvascular abnormalities. Since the global prevalence of diabetes continues to escalate, DR has emerged as a prominent area of research interest. The development and progression of DR encompass a complex interplay of pathological and physiological mechanisms, such as high glucose-induced oxidative stress, immune responses, vascular endothelial dysfunction, as well as damage to retinal neurons. Recent years have unveiled the involvement of genomic and epigenetic factors in the formation of DR mechanisms. At present, extensive research explores the potential of biomarkers such as cytokines, molecular and cell therapies, antioxidant interventions, and gene therapy for DR treatment. Notably, certain drugs, such as anti-VEGF agents, antioxidants, inhibitors of inflammatory responses, and protein kinase C (PKC)-β inhibitors, have demonstrated promising outcomes in clinical trials. Within this context, this review article aims to introduce the recent molecular research on DR and highlight the current progress in the field, with a particular focus on the emerging and experimental treatment strategies targeting the immune and redox signaling pathways.

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Section: Anti-inflammatory Drugsmentioning

confidence: 99%

Diabetic Retinopathy: New Treatment Approaches Targeting Redox and Immune Mechanisms

Tang,

Buonfiglio,

Böhm

et al. 2024

Antioxidants

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Topical bromfenac in VEGF-driven maculopathies: topical review and meta-analysis

Kulikov,

Vasiliev,

Kalinicheva

et al. 2024

BMC Ophthalmol

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Background Topical non-steroidal anti-inflammatory drugs have the potential to reduce treatment burden and improve outcomes of anti-VEGF therapy for a number of retinal disorders, including neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusions. In this review, we focused on the advantages of topical bromfenac as an adjunct to intravitreal anti-VEGF therapy in VEGF-driven maculopathies. Methods Cochrane Library, PubMed, and EMBASE were systematically reviewed to identify the relevant studies of neovascular age-related macular degeneration, diabetic macular edema, macular edema associated with retinal vein occlusion, myopic choroidal neovascularization, and radiation maculopathy which reported changes in central retinal thickness, visual acuity, and the number of anti-VEGF injections needed when anti-VEGF therapy was combined with topical bromfenac. Results In total, ten studies evaluating bromfenac as an adjunct to anti-VEGF therapy were identified. Five studies were included in meta-analysis of the number of injections and five studies were included in the analysis of changes in central retinal thickness. A statistically significantly lower number of intravitreal injections (p = 0.005) was required when bromfenac was used as an adjunct to anti-VEGF therapy compared to anti-VEGF monotherapy with pro re nata regimen. At the same time, eyes receiving bromfenac as an adjunct to anti-VEGF therapy demonstrated non-inferior outcomes in central retinal thickness (p = 0.07). Except for one study which reported better visual outcomes with combined treatment, no difference in visual acuity or clinically significant adverse effects were reported. Conclusions This literature review and meta-analysis showed that topical bromfenac can be considered as a safe adjunct to anti-VEGF therapy with a potential to reduce the treatment burden with anti-VEGF drugs requiring frequent injections without compromising improvement of central retinal thickness or visual acuity.

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Evaluation of topical bromfenac as an adjunctive treatment with intravitreal ranibizumab in the management of diabetic macular edema

Emara,

Tabl,

El-Tohamy

et al. 2024

Journal of the Egyptian Ophthalmological Society

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Background and purpose Intravitreal injection of anti- vascular endothelial growth factor medications has transformed the therapy of diabetic macular edema (DME). The purpose of this study was to evaluate the safety and efficacy of topical bromfenac as an adjunctive therapy to intravitreal ranibizumab injections in patients diagnosed with DME. Study design Prospective, randomized, controlled clinical trial. Patients The study included 40 eyes of patients with DME, divided into two groups: group I (20 eyes) received intravitreal ranibizumab injections and adjunctive topical bromfenac twice daily; group II (20 eyes) received only intravitreal ranibizumab injections. Methods All patients underwent assessments for best corrected visual acuity (BCVA), intraocular pressure, anterior segment, and fundus examination. Optical coherence tomography of the macula was repeated at 1, 3, and 6 months after the last injection. Results At 6 months, group I demonstrated significantly worse BCVA compared with group II (P=0.021). In group II, the 6-month change in central macular thickness from baseline was significantly greater in patients aged less than or equal to 60 years compared with those greater than 60 years (median = –170.5 μm vs. −40 μm, respectively; P=0.001) and in females compared with males (median = –75 μm vs. −23.4 μm; P=0.012). No significant differences were observed concerning the duration of diabetes (P=0.238), HbA1c levels (P=0.315), or laterality (P=0.792). Conclusion Topical bromfenac, when combined with intravitreal ranibizumab, showed some efficacy in the management of DME over a 6-month follow-up period, although the results were not statistically significant.

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Topical bromfenac as adjunctive treatment with intravitreal ranibizumab for diabetic macular edema

Cited by 3 publications

References 24 publications

Diabetic Retinopathy: New Treatment Approaches Targeting Redox and Immune Mechanisms

Diabetic Retinopathy: New Treatment Approaches Targeting Redox and Immune Mechanisms

Topical bromfenac in VEGF-driven maculopathies: topical review and meta-analysis

Evaluation of topical bromfenac as an adjunctive treatment with intravitreal ranibizumab in the management of diabetic macular edema

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