People with diabetic macular edema may receive eye injections to help control their symptoms. These shots can help to improve vision and also stop the damage that causes vision issues to get worse. Multiple eye injections have been approved to treat diabetic macular edema. Most of these medicines are called anti-VEGF therapies because they block a substance in the eye called VEGF.
In 2022, Vabysmo became the first eye injection that could block two substances (VEGF and another substance called Ang-2) in people with diabetic macular edema. This may allow people to get their shots less often.
How Does Vabysmo Work for Diabetic Macular Edema?
Over time, people with diabetes may develop eye problems. One of the most common eye conditions caused by diabetes is called diabetic retinopathy. This condition affects the retina, which is the layer of the eye that processes the images that you see. When blood sugar levels stay high for a long time in people with diabetes, it can damage small blood vessels. Damaged blood vessels can slowly leak fluid and blood into the retina. As diabetic retinopathy gets worse, the eye may begin to form new blood vessels to replace the leaky ones. This is called proliferative diabetic retinopathy.
People with proliferative diabetic retinopathy may develop another eye condition called macular edema. The macula is the part of the retina that processes the images in the center of your vision (right in front of you). In macular edema, the macula swells and thickens. This can cause changes to your vision, such as blurry vision, double vision, floating spots, and dull colors. Some people may also lose part or all of their central vision.
The key to treating diabetic macular edema is to limit or stop the damage to the retina. Stopping the damage can help to improve vision and may also help to keep vision problems from getting worse. Some medicines that are injected into the eye can help to stop this eye damage. Most of these medicines work by blocking a substance called VEGF, which plays an important part in forming new blood vessels in the eye. By blocking VEGF, these medicines can slow down the formation of new blood vessels.
The active ingredient in Vabysmo is a medicine called faricimab. Like some of the other medicines that are used to treat diabetic macular edema, this medicine blocks VEGF. Unlike those other medicines, Vabysmo also blocks another substance called Ang-2. Having too much Ang-2 in the eye can make blood vessels unstable and leaky. By blocking both VEGF and Ang-2, Vabysmo can stop the eye from growing as many new blood vessels and also help to make the current blood vessels more stable. This can reduce the leakiness and fluid buildup that causes vision issues.
How Was It Studied?
Two clinical studies were done to see if Vabysmo was safe and effective for the treatment of diabetic macular edema. Everyone was at least 18 years old, with an average age of 62. A little more than half of the people in the studies were male (60%). Most of the people in the studies were White (78%), about 10% were Asian, and about 6% were Black. About 17% of people identified as Hispanic or Latino. Less than 1% of people identified as Native Hawaiian or other Pacific Islander, and less than 1% identified as American Indian or Alaska native.
All of the people in these studies had diabetes, and almost all of them (94%) had type 2 diabetes. Everyone also had diabetic macular edema. On average, people had been diagnosed with macular edema about 1.5-2 years before the study started.
In both of these studies, Vabysmo was compared with another medicine, called aflibercept (Eylea). Aflibercept blocks VEGF and is injected into the eye. The people in the studies did not know which medicine they were receiving. During the study, everyone received injections multiple times, but some people had them more often than other people. Depending on the person and the medicine they were receiving, the shots could be given every 4 weeks, 8 weeks, 12 weeks, or 16 weeks.
These studies measured efficacy by testing each person’s best possible vision while wearing their glasses or contacts. This test was done before the study started and again after a year. Since vision can change from day to day, everyone in the study completed the test multiple times to make sure that the test was accurate.
What Benefits Were Seen in These Studies?
Overall vision. After a year of treatment, people who used Vabysmo could see better than they could before the study started. People who used aflibercept could also see better than they could before the study started. These improvements in vision were similar for everyone in the study, no matter which medicine they were using.
Total number of shots needed. Everyone received the medicine once every month when the study first started, but then the injection schedule changed. Some people received Vabysmo every 8 weeks for the rest of the year. Other people were placed on a “personal dosing schedule” and got Vabysmo every 4 weeks, 8 weeks, 12 weeks, or 16 weeks. In order to decide how often to give the injection, a health care professional examined each person’s eyes.
- Most of the people on the “personal dosing schedule” (more than 70%) only needed a dose of Vabysmo every 12-16 weeks (or every 3-4 months). These people had the same vision improvements as the people who used Vabysmo every 8 weeks (or every 2 months).
- The people who used aflibercept got an injection every 4 weeks for the first 5 months. After that, they got an injection every 8 weeks. These people had the same improvements in their vision as the people who got Vabysmo every 12-16 weeks.
Does the Medicine Keep Working After the First Year?
Both of these studies were continued for 2 full years. On average, the people in the studies were able to see about as well after 2 years as they had after 1 year. Since diabetic macular edema causes vision to get worse over time, this means that both of these medicines were helping to stop the damage to the eye.
Most of the people on the “personal dosing schedule” (about 78%) only needed a dose of Vabysmo every 12-16 weeks (or every 3-4 months), even after using the drug for 2 full years. These people were able to see as well after 2 years as they had after 1 year on the medicine, just like the people who received the medicine more often. This means that many people who use Vabysmo may only need a shot every 3-4 months (once they have received their first four shots).
How Do I Use It?
Vabysmo is a liquid that is injected directly into the eye by a health care professional. This type of shot is called an intravitreal injection. When you first start using Vabysmo, you will receive an injection every 4 weeks. After four doses, your health care professional will order tests to evaluate your eye function. After ordering these tests, you may continue to receive Vabysmo every 4 weeks, 8 weeks, 12 weeks, or 16 weeks. Most people only need a dose every 12-16 weeks. Your health care professional will decide how often you should receive Vabysmo and for how long.
When it is time to get your shot, your health care professional will set up a device that will hold your eye open. Then they will place some drops into your eye. These drops will help to numb your eye during the shot and prevent infections. Before giving the injection, they may also wash out your eye with a solution that kills bacteria.
The pressure in your eye might increase right after you get the Vabysmo shot. This increased pressure usually goes away within an hour. Your health care provider will monitor your eye and your symptoms after each injection. During that time, it is important for you to let someone know if you have any pain in the eye or major changes to your vision.
How Quickly Will Vabysmo Work for Diabetic Macular Edema?
If Vabysmo is working, you will start to notice your vision improve within the first few weeks after your first injection. Over the next few months, you will receive an injection every 4 weeks, and your vision may continue to get better during this time.
It is important that you go to every appointment and receive all of your scheduled shots. If you will not be able to make it to an appointment, call your health care provider right away to reschedule.
How Can I Prevent or Manage Side Effects?
Your vision may become blurry for a little while after you receive your Vabysmo injection. This short-term blurry vision is a normal side effect. While you wait for your vision to return to normal, it is best not to drive or operate any machinery.
In rare cases, Vabysmo can cause other types of changes to your vision, such as seeing floating dark spots or lines, flashing lights, or the sense that a curtain has been drawn over parts of your eye. These vision changes may be a sign of a serious condition. If you have any of these vision changes or have severe eye pain, seek medical help right away.
These are not all of the possible side effects of Vabysmo. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Vabysmo, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
Are There Any Interactions With Other Medicines?
There are no known interactions between Vabysmo and other medicines. But it is still important for your health care provider to be aware of all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken.
Is There a Coupon Card Available?
There is a savings coupon available from the drugmaker that may allow you to pay $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance, and what type of insurance you have. You can find out more at https://www.vabysmo.com/dme/financial-support/assistance-options.html.
