| Title: |
Aflibercept and Brolucizumab in Diabetic Macular Edema: A Focused Review of Efficacy, Safety, and Clinical Considerations |
| Authors: |
Ana Maria Dascalu; Catalin Cicerone Grigorescu; Ece Ergin; Cristina Alexandrescu; Dan Dumitrescu; Marina Ionela Nedea; Bogdan Mihai Cristea; Dragos Serban; Laura Carina Tribus; Tudor Mihai Badescu |
| Source: |
Biomedicines ; Volume 14 ; Issue 3 ; Pages: 501 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
diabetic retinopathy; diabetic macular edema; anti-VEGF therapy; aflibercept; brolucizumab; intravitreal injections |
| Description: |
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. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Molecular and Translational Medicine; https://dx.doi.org/10.3390/biomedicines14030501 |
| DOI: |
10.3390/biomedicines14030501 |
| Availability: |
https://doi.org/10.3390/biomedicines14030501 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.B9937684 |
| Database: |
BASE |