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New £800-a-dose jab offers hope for diabetics suffering macular oedema

A drug that could save diabetics from going blind is now being offered by the NHS. Brolucizumab treats fluid buildup in the eyes – called diabetic macular edema – that can lead to blurred vision and eventual vision loss.

Currently, diabetics with the condition have to go to hospital every six to eight weeks for injections of other drugs in the eyes that block the formation of weak and leak-prone blood vessels.

But with brolucizumab – which privately costs £800 per dose – patients only need a session once every three months, while studies show it’s also better at slowing the progression of long-term problems.

A drug that could save diabetics from going blind is now offered on the NHS

A drug that could save diabetics from going blind is now offered on the NHS

Mr Winfried Amoaku, consultant ophthalmologist at Nottingham University Hospitals NHS Trust, said: ‘When I first saw the results of the trial I was ecstatic.

‘The introduction of brolucizumab will change patients’ lives.’

Diabetic macular edema – an edema is a buildup of fluid that can occur anywhere in the body – is the most common cause of vision loss in adults of working age, affecting about 22,000 Britons a year.

It occurs when elevated blood sugar levels caused by diabetes damage small blood vessels in the retina of the eye, which then leak fluid into the macula — a small portion responsible for color and detailed vision.

Symptoms include blurred vision, faded colors and difficulty seeing in the dark.

Over time, cells in the macula become overwhelmed with moisture and begin to die. This damage, if left untreated, is irreversible and causes blindness. It usually takes several years to reach this point, which is why an annual screening is offered to all diabetics over the age of 12 to nip any problems in the bud.

Brolucizumab, injected directly into the eyes, blocks a protein called vascular endothelial growth factor (VEGF) and prevents the formation of weak blood vessels in the eye that are more prone to leaking.

“It’s like repairing a burst pipe,” explained Mr. Amoaku. “Once the leak is sealed, the fluid in the macula is slowly reabsorbed into the bloodstream and the patient’s vision is restored.”

Diabetic macular edema an edema is a buildup of fluid that can occur anywhere in the body ¿ is the most common cause of vision loss in adults of working age, affecting about 22,000 Britons a year

Diabetic macular edema an edema is a buildup of fluid that can occur anywhere in the body ¿ is the most common cause of vision loss in adults of working age, affecting about 22,000 Britons a year

Diabetic macular edema – an edema is a buildup of fluid that can occur anywhere in the body – is the most common cause of vision loss in working-age adults, affecting around 22,000 Britons every year

The two commonly used anti-VEGF injections are ranibizumab and aflibercept. These are given once a month for three months, which can be spread out to once every six to eight weeks once the condition has resolved.

Brolucizumab, on the other hand, binds more strongly with VEGF proteins, making the effects last much longer.

In one trial, researchers found that 55 percent of patients successfully transitioned to receiving injections every three months. They also found that 40 percent of those taking brolucizumab had their edema completely resolved, compared with 27 percent of those taking aflibercept.

Another treatment uses a laser to seal leaking blood vessels. However, it only works on fluid that has accumulated on the periphery of the macula, otherwise the treatment itself can cause vision loss. It means that about half of diabetic macular edema patients are not eligible for it.

One patient who is benefiting from the newly approved drug is Bernadette Warren, 53, of Camberley, Surrey. The mother of two has received nearly 100 injections over the past decade to treat the diabetic macular edema that blinded her left eye.

When she was diagnosed with type 1 diabetes in 1996, at the age of 27, she first noticed that her vision became blurry in 2010. Despite laser treatment, the condition returned the following year and she was told she would need continued injections in both her eyes. She said, “I was terrified. Nobody wants a needle near their eye.’

Despite trying various medications, her vision continued to deteriorate. In 2013, she lost sight in her left eye and had to give up her job as a teacher. She also had to surrender her driver’s license. Then, in 2016, her right eye deteriorated.

She added: ‘I would really like to try brolucizumab because I would appreciate it so much that I didn’t have to go to the hospital every month and feel normal for a change.

“I’m also optimistic that it can help stabilize my vision. I want to see my kids get married and see my grandkids someday, and this drug gives me hope that I will.”

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