The NHS is now offering a medication that can prevent diabetics from going blind. Brolucizumab is used to treat diabetic macular edema, a condition that can cause impaired vision and, eventually, blindness.
Currently, diabetics with the condition must visit the hospital every six to eight weeks to receive injections of various medications into the eyes, which prevent the creation of blood vessels that are fragile and prone to leaking.
However, with brolucizumab, which costs £800 per dose privately, patients will only require a session once every three months, and clinical trials have shown that it is also superior at reducing the course of chronic issues.
Mr. Winfried Amoaku, the consultant ophthalmologist at Nottingham University Hospitals NHS Trust, remarked, “When I initially saw the study findings, I was elated.”
The introduction of brolucizumab will transform the lives of patients.
Diabetic macular edema — a fluid accumulation that can occur anywhere in the body — is the most prevalent cause of visual loss in individuals of working age, affecting approximately 22,000 Britons annually.
Diabetes-related high blood sugar levels damage microscopic blood vessels in the retina of the eye, which subsequently leak fluid into the macula — a tiny area crucial for color and detail vision.
Symptoms include impaired vision, colors that appear washed out, and trouble seeing in the dark.
Over time, the macula’s cells are overcome by fluid and begin to perish. This damage is irreversible and causes blindness if left untreated. It typically takes several years to reach this position, thus all diabetics over the age of 12 are screened annually to prevent complications.
Injected directly into the eyes, brolucizumab inhibits the production of vascular endothelial growth factor (VEGF) and prevents the creation of blood vessels in the eye that is more susceptible to leaking.
Mr. Amoaku explained, “It’s analogous to repairing a broken pipe.” Once the leak has been repaired, the fluid in the macula is progressively reabsorbed into the bloodstream, restoring the patient’s eyesight.
The two most common anti-VEGF injections are ranibizumab and aflibercept. These are administered once each month for three months, and then every six to eight weeks once the situation has stabilized.
Brolucizumab, on the other hand, binds more firmly to VEGF proteins, resulting in significantly longer-lasting effects.
In a clinical trial, 55% of patients successfully transitioned to getting injections every three months. In addition, they found that edema disappeared in 40% of individuals who received brolucizumab, compared to 27% of those who received aflibercept.
Another treatment involves using a laser to seal blood vessel leaks. However, it only works on fluid that has accumulated at the macula’s perimeter; otherwise, the treatment itself can induce vision loss. This means that around half of diabetic macular edema patients are ineligible for treatment.
Bernadette Warren, 53, of Camberley, Surrey, is one of the patients who would benefit from the newly-approved medication. To cure the diabetic macular edema that blinded her left eye, the mother-of-two has taken approximately 100 injections over the past decade.
2010 was the first year she noticed her vision was growing hazy after being diagnosed with type 1 diabetes in 1996 at age 27. The disease recurred the next year despite laser treatment, and she was informed that she would require regular injections in both eyes. She remarked, “I was terrified.” No one desires to have a needle near their eye.
Despite attempting various medications, her vision continued to deteriorate. Due to the loss of vision in her left eye in 2013, she was forced to quit her position as a teacher. In addition, she had to surrender her driver’s license. In 2016, her right eye deteriorated further.
She added, “I would so enjoy not having to go to the hospital every month and feeling normal for a change if I could try brolucizumab.”
I am also hopeful that it will assist to stabilize my vision. This medication offers me hope that I will one day see my children’s weddings and my grandchildren’s births.
