Ahmedalgabri Rayan Hamza Mohammed, Omer Tarig, Zarroug Fatima, Elkhawad Abdullah Omer, Noma Mounkaila
Department of Pharmacology, University of Medical Science and Technology, Riyadh, Khartoum, Sudan.
Vitreo Retinal Department, Alfaisal Eye Centre, Riyadh, Khartoum, Sudan.
Clin Pharmacol. 2022 Apr 5;14:37-47. doi: 10.2147/CPAA.S338926. eCollection 2022.
Anti-vascular endothelial growth factor (anti-VEGF) medicines have revolutionized DME and DR treatment. Despite the worldwide use of anti-VEGFs, their use remains limited in Sudan. This study aimed to assess the impact of anti-VEGF (ranibizumab and bevacizumab) injections in patients with diabetic macular oedema in Khartoum, Sudan.
An analytical comparative cross-sectional study was implemented in Alfaisal referral eye centre. A Standard questionnaire was used to collect the variables related to the research objectives. Thirty-four patients were recruited; 16 patients under ranibizumab (Lucentis) and 18 under bevacizumab (Avastin). Data were analyzed through SPSS 23, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measurements were considered as main outcomes to evaluate the treatment effectiveness.
Among the 34 participants, 64.7% were males and 35.3% were females, with an average age of 62 years and 13 years of long standing diabetes. A total of 54 eyes received an average of 2.3 injections in an average of 7 months' period. The mean BCVA before and after treatment for both drugs respectively 0.19 min and 0.21 min was statistically correlated ( = 0.000). For patients under Lucentis, the mean BCVA before and after medication was 0.20 min-0.24 min and 0.19-0.19 min for those who used Avastin. The mean central retinal thickness (CRT), before and after treatment for both drugs, was 492.22µm-422.89µm, respectively, with a significant correlation ( = 0.003). For patients under Lucentis, the mean CRT decreased from 536.30 µm to 425.19 µm; it dropped from 453.16µm to 421.18µm for patients under Avastin. About 79.4% (27/34) of the participants reported that injections were not affordable and 14.7% (5/34) complained from shortage of one dose, regardless of which type of treatment. Glycaemia control, duration of treatment, type and frequency of injections used were found to be the most contributing factors to the effectiveness of anti-VEGF medications.
Both anti-VEGF medications are effective in treating DME, Lucentis showed better improvements in BCVA and macular thickness than Avastin. Policymakers in Sudan require urgent alternative strategies to increase access to these medications.
抗血管内皮生长因子（anti-VEGF）药物彻底改变了糖尿病性黄斑水肿（DME）和糖尿病视网膜病变（DR）的治疗方式。尽管抗VEGF药物在全球范围内广泛使用，但在苏丹其应用仍然有限。本研究旨在评估抗VEGF（雷珠单抗和贝伐单抗）注射对苏丹喀土穆糖尿病性黄斑水肿患者的影响。
在阿尔法伊萨尔转诊眼科中心开展了一项分析性比较横断面研究。使用标准问卷收集与研究目标相关的变量。招募了34名患者；16名接受雷珠单抗（Lucentis）治疗，18名接受贝伐单抗（Avastin）治疗。通过SPSS 23进行数据分析，将最佳矫正视力（BCVA）和中心视网膜厚度（CRT）测量结果作为评估治疗效果的主要指标。
在34名参与者中，64.7%为男性，35.3%为女性，平均年龄62岁，糖尿病病程13年。共有54只眼睛在平均7个月的时间里平均接受了2.3次注射。两种药物治疗前后的平均BCVA分别为0.19和0.21，具有统计学相关性（P = 0.000）。接受Lucentis治疗的患者，用药前后的平均BCVA分别为0.20 - 0.24和0.19 - 0.19；使用Avastin的患者为0.19 - 0.19。两种药物治疗前后的平均中心视网膜厚度（CRT）分别为492.22µm - 422.89µm，具有显著相关性（P = 0.003）。接受Lucentis治疗的患者，平均CRT从536.30µm降至425.19µm；接受Avastin治疗的患者，从453.16µm降至421.18µm。约79.4%（27/34）的参与者表示注射费用难以承受，14.7%（5/34）抱怨缺一剂药，无论接受哪种治疗。血糖控制、治疗持续时间、所用注射剂的类型和频率被发现是抗VEGF药物疗效的最主要影响因素。
两种抗VEGF药物在治疗DME方面均有效，Lucentis在BCVA和黄斑厚度改善方面比Avastin表现更好。苏丹的政策制定者急需采取替代策略以增加这些药物的可及性。
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