Challenges in DME Management

EP: 1.Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Therapies in Neovascular AMD and DME

EP: 2.Treatment Goals in Neovascular AMD

EP: 3.Phase 3 Studies of Faricimab in Neovascular AMD

EP: 4.Use of Faricimab in Neovascular AMD in Clinical Practice

EP: 5.Patient Selection for Faricimab Treatment in Neovascular AMD

EP: 6.Safety of Faricimab in Neovascular AMD

EP: 7.Loading Dose Recommendations of Faricimab in Neovascular AMD

EP: 8.Biomarkers of Disease at Baseline in Neovascular AMD

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EP: 9.Challenges in DME Management

EP: 10.Key Outcomes of Trials of Faricimab in DME

EP: 11.The YOSEMITE and RHINE Trials in DME

EP: 12.Use of Intraocular Steroids in DME

EP: 13.Faricimab Loading Dose Adherence in DME Therapy

EP: 14.Emerging Therapies in Neovascular AMD and DME

EP: 15.New Therapies to Supplement Anti-VEGF Treatments in Neovascular AMD and DME

EP: 16.Gene Therapy in Neovascular AMD and DME

EP: 17.Approaches to Step Therapy in Neovascular AMD and DME

EP: 18.Role of Biosimilars in Neovascular AMD and DME Treatment

EP: 19.Managing Concurrent Neovascular AMD and Geographic Atrophy (GA)

EP: 20.Key Takeaways on Managing Neovascular AMD and DME

EP: 21.Poll: Exploring the dosing intervals of faricimab for treating neovascular AMD in the clinical practice setting

EP: 22.Poll: What are the biggest challenges in DME Management?

EP: 23.Neovascular AMD and DME therapies: 5 quotes from retina specialists

EP: 24.Poll: Most anticipated emerging therapies in neovascular AMD and DME

Nathan Steinle, MD: Let’s switch topics to DME [diabetic macular edema]. Dr Rao, this is a different patient population with some unique challenges. Tell us about your typical patient with DME and why they might be different and difficult to treat vs the AMD [age-related macular degeneration] population.

Prethy Rao, MD, MPH: It’s almost like night and day: the complete opposite end of the spectrum. We’re dealing with more of an ocular and systemic disease rather than a purely ocular disease. We’re fighting not only their eye disease. Are they able to control their diabetes? That plays a role. First, we look at how well their systemic will control for diabetes.

The second thing is that, unfortunately, a lot of patients with diabetes don’t recognize they have diabetes for a while, so there’s a delayed presentation. What we’re doing with DME is the chronicity of it. That DME might have been there for months or years, so we’re starting behind the eight ball. We’re dealing with all these inflammatory factors that are at a very high level. It’s not only a VEGF-driven process. It’s the inflammation part. Multiple biomarkers contribute to this disease process, so we’re dealing with different factors.

Nathan Steinle, MD: It’s a very heterogeneous disease. How do you account for your success? How do you market your success? What do you consider success?

Adrienne Scott, MD: Generally speaking, you want to have a patient maximize his or her visual outcome, but treatment burden is very important to consider. This is a working-age population. Unfortunately, coverage for these types of treatments is tied to certain employment characteristics. Are they insured? How are they insured? Unfortunately, this dictates and influences what treatments we recommend. You have systemic disease, and that’s going to influence how frequently they can come in. Other appointments may take precedence over their injection appointment. You have the working-age factor—taking time off to come for frequent injections is often a challenge. We’re fighting social determinants of health as well. We’re treating diabetic macular edema, but we also have to work with the patient’s ability to undergo these particular treatment regimens.

Transcript edited for clarity