Black patients may experience less vision improvement after bevacizumab for DME

This retrospective cohort analysis examined the impact of race and ethnicity on the efficacy of intravitreal bevacizumab for diabetic macular edema (DME).

Study design

Researchers included anti-VEGF-naïve patients seen between 2010 and 2019 at an urban-based academic institution with affiliated private offices. They assessed 314 medical charts for single injection analysis and 151 for the 3-injection analysis. The main outcome was the percentage of patients with visual acuity improvement and mean percentage reduction in central macular thickness (CMT). In addition to race and ethnicity, the analysis considered variables such as age, sex, baseline glycated hemoglobin, baseline CMT, baseline visual acuity, laser history, injection time course and delay to follow-up.

Outcomes

Visual acuity improvements were 27%, 39% and 50% after 1 injection and 34%, 55% and 59% after 3 injections for Black, Hispanic, and White cohorts, respectively. After adjusting for covariables, Black patients were less likely to have visual acuity improvements than White and Hispanic patients after 1 and 3 injections.

Limitations

This study was limited by its retrospective study design, a relatively small sample size and follow-up.

Clinical significance

This study revealed that Black patients experience worse anatomic and visual responses to bevacizumab for DME compared with White and Hispanic patients and highlights the need for further study. These findings emphasize the importance of ensuring inclusion of minority patients—especially Black patients—in clinical trials.