Pre-therapeutic Biomarkers for Ranibizumab Therapy among Type 2 Diabetic Patients with Diabetic Macular Edema. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Paine, Suman K.; Bhattacharjee, Chandra K.; Bhaduri, Gautam; Pramanik, Subhasish; Borah, Prasanta K.; Mahanta, Jagadish; Basu, Analabha; Mondal, Lakshmi K.
• Is Part Of: Optometry and vision science. Volume 98:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: Optometry -- Periodicals; Physiological optics -- Periodicals; Vision disorders -- Periodicals; 617.7505
• DOI: 10.1097/OPX.0000000000001622
• Languages: English
• ISSNs: 1040-5488

Abstract

Abstract : SIGNIFICANCE: A differential outcome in randomized controlled trials of anti–vascular endothelial growth factor (anti-VEGF) therapy, including ranibizumab, for diabetic macular edema is a major dilemma for planning, optimizing, and managing clinical usage. The variable outcome of the therapeutics necessitates the importance of finding a predictive biomarker for anti-VEGF therapy to improve subject selection. PURPOSE: Our study correlates the baseline pro- and anti-VEGF isoforms and its three receptors (VEGFReceptor1, VEGFReceptor2, and VEGFReceptor3) for circulatory candidate protein molecules among diabetic patients with macular edema, with the clinical outcome of ranibizumab therapy. METHODS: This study included 86 individuals who were anti-VEGF naive at the time of ascertainment but have completed the standardized therapy regimen of the clinic. Plasma proteins for pro- and anti-VEGF isoforms and its three receptors were determined in replicate by an enzyme-linked immunosorbent assay. RESULTS: The study demonstrated that 56 (65.12%) individuals benefited from the therapy in terms of letter gain (Snellen chart). Baseline plasma soluble VEGF receptor 2 (sVEGFR-2) was significantly higher among responders (65.10 pg/mL; 95% confidence interval, 55.41 to 74.80 pg/mL) compared with nonresponders (46.38 pg/mL; 95% confidence interval, 38.69 to 54.07 pg/mL; P FDR = .03). Diffuse diabetic macular edema with proliferative diabetic retinopathy increases the risk of nonresponse to the therapy by 3.03-fold ( P FDR = .04). CONCLUSIONS: The present study postulates that diffuse diabetic macular edema with proliferative diabetic retinopathy and baseline circulatory soluble VEGF receptor 2 may be potential candidates as therapy-stratifying markers for ranibizumab treatment among patients with diabetic macular edema. Abstract : Supplemental digital content is available in the text.