Aflibercept and Brolucizumab in Diabetic Macular Edema: A Focused Review of Efficacy, Safety, and Clinical Considerations.
| Title: | Aflibercept and Brolucizumab in Diabetic Macular Edema: A Focused Review of Efficacy, Safety, and Clinical Considerations. |
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| Authors: | Dascalu AM; Doctoral School, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Grigorescu CC; Facultyof Medicine, 'Vasile Goldis' Western University of Arad, 310130 Arad, Romania.; Ergin E; Doctoral School, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.; Alexandrescu C; Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Dumitrescu D; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Nedea MI; Faculty of Pharmacy, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Cristea BM; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Serban D; Doctoral School, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Tribus LC; Faculty of Dental Medicine, 'Carol Davila' University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.; Badescu TM; Faculty of Medicine, 'Lucian Blaga' University of Sibiu, 550169 Sibiu, Romania. |
| Source: | Biomedicines [Biomedicines] 2026 Feb 25; Vol. 14 (3). Date of Electronic Publication: 2026 Feb 25. |
| Publication Type: | Journal Article; Review |
| Language: | English |
| Journal Info: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101691304 Publication Model: Electronic Cited Medium: Print ISSN: 2227-9059 (Print) Linking ISSN: 22279059 NLM ISO Abbreviation: Biomedicines Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI AG, [2013]- |
| Abstract: | Background/Objectives: Diabetic macular edema (DME) are major causes of visual impairment worldwide, with vascular endothelial growth factor (VEGF) playing a central role in disease pathogenesis. Intravitreal anti-VEGF therapy is the current standard of care for center-involving DME. Methods: This narrative review summarizes and compares the pharmacological properties, clinical efficacy, safety, and real-world performance of aflibercept and brolucizumab in the treatment of DME, based on randomized controlled trials and observational studies published between 2014 and 2025. Results: Both agents demonstrate significant improvements in visual acuity and retinal anatomy. Brolucizumab has shown non-inferior visual outcomes and, in several studies, greater reductions in central retinal thickness with the potential for extended dosing intervals, suggesting reduced treatment burden. However, post-marketing data have identified an increased risk of intraocular inflammation, including retinal vasculitis and retinal vascular occlusion, associated with brolucizumab, which has influenced its clinical use. Conclusions: Both aflibercept and brolucizumab are effective anti-VEGF therapies for diabetic macular edema, but they differ in durability and safety considerations. Aflibercept remains a reliable first-line option for many patients, while brolucizumab may be considered in carefully selected cases where treatment burden is a priority. Individualized treatment selection based on clinical characteristics, patient preferences, and safety considerations is essential for optimizing long-term outcomes. |
| Contributed Indexing: | Keywords: aflibercept; anti-VEGF therapy; brolucizumab; diabetic macular edema; diabetic retinopathy; intravitreal injections |
| Entry Date(s): | Date Created: 20260328 Date Completed: 20260328 Latest Revision: 20260330 |
| Update Code: | 20260420 |
| PubMed Central ID: | PMC13023600 |
| DOI: | 10.3390/biomedicines14030501 |
| PMID: | 41898148 |
| Database: | MEDLINE |
Journal Article; Review