COED trial: Combination steroid and anti-VEGF therapy in treatment of diabetic macular edema

Ash Abbey, MD, discusses the COED trial, testing the efficacy of combining steroid and anti-VEGF therapy in patients with diabetic macular edema.

Ashkan Abbey, MD, presented his talk entitled, “Impact of Steroid Use on Diabetic Macular Edema,” at the American Society of Retina Specialists 39th Annual Scientific Meeting in San Antonio, Texas.

Dr. Ash Abbey practices at Texas Retina Associates, and he is also a clinical assistant professor of ophthalmology at UT Southwestern Medical Center.

Video transcript

Ashkan Abbey, MD: So we're doing a prospective randomized trial where we're comparing the use of combination of steroid and anti-VEGF in one arm of the trial, versus anti-VEGF monthly therapy by itself in patients with diabetic macular edema that are either treatment naive, or have had a washout period of at least three months with no previous history of steroid treatment.

And this is just an early preliminary analysis; we have more data coming as we just recently fully enrolled this trial. The name of the trial is the COED trial. But what we found so far in the preliminary analysis is that visual outcomes at six months—in the small number of patients that we've gotten to that point—have been equivalent between the two groups. A central subfield thickness on OCT outcomes, the difference has been relatively equivalent as well. And there seems to be a trend towards using less injections in the patients who receive combination therapy with steroid and anti-VEGF compared to just anti-VEGF alone. So they’ve required less injections slightly so far, in the patients who got the combo therapy.

This is a step forward for us and looking at putting together steroid and anti-VEGF, and I think we're excited to embark on the NEW DAY trial with Alimera. We're just getting started with that trial now at our site, and we're looking forward to enrolling more patients in it. But I think it's again, an extension of what we've already been doing here: trying to both attack inflammatory cytokines and the inflammation that we all know is also prevalent in these diabetic eyes with retinopathy. We're trying to attack that in addition to the VEGF, which we know mediates a lot of the disease process as well. We really have to focus on treating both of these pathways, both the inflammatory pathway and the VEGF mediated pathway to really get the best success for our patients overall in these diabetic macular edema eyes.

The American Society of Retina Specialists (ASRS) hosted its 39th Annual Scientific Meeting from October 8-12, 2021, at the JW Marriott San Antonio Hill Country Resort and Spa in San Antonio, Texas.

According to ASRS, its 2021 scientific program offered attendees innovations in retina science, clinical practice, and surgery with 148 papers, 165 posters, 46 papers on demand, and 69 films, as well as a wide range of networking opportunities and the chance to exchange ideas and perspectives with peers.

Related Content: Additional ASRS 2021 Content | Conference Coverage | Ophthalmology