阿柏西普与布罗鲁珠单抗在糖尿病性黄斑水肿中的对比

Aflibercept Versus Brolucizumab in Diabetic Macular Edema - A 2026 Clinical Review

Thailand Medical News 等信源发布 2026-02-26 09:42

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: A major new scientific review has carefully examined two leading injectable treatments for diabetic macular edema, a serious eye complication of diabetes that can result in permanent vision loss. The study compares aflibercept and brolucizumab, two anti-VEGF medications that reduce retinal swelling and help protect sight..

：一项重要的新科学综述仔细审查了两种治疗糖尿病性黄斑水肿的主要注射药物，糖尿病性黄斑水肿是糖尿病的一种严重眼部并发症，可能导致永久性视力丧失。该研究比较了阿柏西普和布罗鲁珠单抗，这两种抗VEGF药物能够减轻视网膜肿胀并帮助保护视力。

A comprehensive 2026 review compares two leading injectable therapies for diabetic macular edema, highlighting

2026年的一项全面审查比较了两种领先的糖尿病性黄斑水肿注射疗法，重点介绍了

differences in durability and safety.

耐用性和安全性方面的差异。

The research was conducted by experts from the “Carol Davila” University of Medicine and Pharmacy Bucharest, the Emergency University Hospital Bucharest, the “Vasile Goldis” Western University of Arad, and the “Lucian Blaga” University of Sibiu in Romania. Their comprehensive analysis offers valuable insights for ophthalmologists and patients managing diabetic retinal disease..

该研究由布加勒斯特“卡罗尔·达维拉”医药大学、布加勒斯特急诊大学医院、阿拉德“瓦西里·戈迪斯”西部大学和罗马尼亚锡比乌“卢西安·布拉加”大学的专家进行。他们的综合分析为眼科医生和管理糖尿病视网膜病变的患者提供了宝贵的见解。

Understanding Diabetic Macular Edema

了解糖尿病性黄斑水肿

Diabetic macular edema, commonly referred to as DME, develops when prolonged high blood sugar damages the tiny blood vessels in the retina. These weakened vessels begin to leak fluid into the macula, the central region of the retina responsible for detailed vision. As fluid accumulates, the retina thickens, leading to blurred or distorted sight..

糖尿病性黄斑水肿，常称为DME，是由于长期高血糖损害视网膜中的微小血管而引发的。这些受损的血管开始向黄斑渗漏液体，黄斑是视网膜中负责清晰视力的中心区域。随着液体积聚，视网膜变厚，导致视力模糊或扭曲。

A protein called vascular endothelial growth factor, or VEGF, plays a central role in this process. VEGF increases blood vessel leakage and abnormal growth. Anti-VEGF medications are designed to block this protein, thereby reducing swelling and stabilizing vision.

一种叫做血管内皮生长因子（VEGF）的蛋白质在这一过程中起核心作用。VEGF会增加血管渗漏和异常生长。抗VEGF药物旨在阻断这种蛋白质，从而减少肿胀并稳定视力。

How Aflibercept and Brolucizumab Differ

阿柏西普和布罗鲁珠单抗的区别

Aflibercept is a fusion protein that blocks multiple growth factors, including VEGF-A, VEGF-B, and placental growth factor. It has been widely used for many years and is supported by extensive long-term safety and efficacy data.

阿柏西普是一种融合蛋白，能够阻断多种生长因子，包括VEGF-A、VEGF-B和胎盘生长因子。它已被广泛使用多年，并拥有大量长期安全性和有效性数据的支持。

Brolucizumab, in contrast, is a smaller antibody fragment. Its compact structure allows a higher molar dose to be delivered into the eye, which may lead to stronger and longer-lasting VEGF suppression. This molecular design has raised interest in its potential to extend injection intervals and reduce treatment burden..

相比之下，布罗鲁珠单抗是一种更小的抗体片段。其紧凑的结构允许更高摩尔剂量被递送到眼中，这可能导致更强和更持久的VEGF抑制。这种分子设计引起了人们对其延长注射间隔和减轻治疗负担潜力的兴趣。

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report emphasizes that although both drugs target VEGF, their structural differences influence their durability and safety profiles.

报告强调，尽管这两种药物都针对VEGF，但它们的结构差异会影响其持久性和安全性。

Evidence from Major Clinical Trials

主要临床试验的证据

Landmark trials such as VIVID and VISTA demonstrated that aflibercept significantly improved best-corrected visual acuity and reduced retinal thickness in patients with center-involving DME. These improvements were sustained over long-term follow-up periods of up to three years.

VIVID 和 VISTA 等具有里程碑意义的试验表明，阿柏西普显著提高了中心受累 DME 患者的最佳矫正视力，并减少了视网膜厚度。这些改善在长达三年的长期随访中得以持续。

Meanwhile, the KESTREL and KITE trials showed that brolucizumab achieved vision gains that were non-inferior to aflibercept. In several analyses, brolucizumab produced numerically greater reductions in central retinal thickness. A considerable proportion of patients maintained disease cont

同时，KESTREL 和 KITE 试验表明，brolucizumab 实现的视力增益不低于 aflibercept。在多项分析中，brolucizumab 在中央视网膜厚度方面实现了数值上更大的减少。相当一部分患者维持了疾病控制。

rol on 12-week dosing intervals after the initial treatment phase, suggesting a potential reduction in injection frequency.

在初始治疗阶段后，使用12周的给药间隔，这表明注射频率可能会减少。

Real-world observational studies further confirmed that both medications can improve or stabilize vision. In patients who switched to brolucizumab due to persistent swelling despite other treatments, significant anatomical improvements were observed in some cases.

现实世界的观察性研究进一步证实，这两种药物均可改善或稳定视力。在因其他治疗仍存在持续肿胀而改用布罗鲁珠单抗的患者中，部分病例观察到了显著的解剖学改善。

Safety Profiles Require Careful Consideration

安全性概况需要仔细考虑

Aflibercept has demonstrated a well-established and predictable safety profile over years of use. Reported side effects are generally mild and consistent with intravitreal injection procedures.

阿柏西普在多年的使用中已展现出稳定且可预测的安全性。报告的副作用通常较轻，且与玻璃体内注射程序一致。

Brolucizumab, however, has been associated with a higher incidence of intraocular inflammation, including retinal vasculitis and, rarely, retinal vascular occlusion. Although these events are uncommon, they can be serious and require prompt treatment. The review notes that inflammatory events appear less frequent in diabetic macular edema than in some other retinal diseases, yet careful monitoring remains essential..

然而，Brolucizumab 与较高的眼内炎症发生率相关，包括视网膜血管炎，且罕见情况下会出现视网膜血管阻塞。尽管这些事件并不常见，但可能很严重，需要及时治疗。该综述指出，相较于其他一些视网膜疾病，在糖尿病性黄斑水肿中炎症事件的发生频率似乎较低，但仍需谨慎监测。

Treatment Burden and Long-Term Management

治疗负担与长期管理

DME is a chronic disease requiring repeated injections and ongoing monitoring. Frequent clinic visits can create logistical and financial challenges. Brolucizumab’s potential for longer dosing intervals may benefit selected patients who struggle with frequent appointments. However, safety considerations must be weighed against convenience..

DME是一种需要反复注射和持续监测的慢性疾病。频繁的门诊就诊可能会带来后勤和经济上的挑战。Brolucizumab延长给药间隔的潜力可能使难以频繁就诊的特定患者受益。然而，必须在安全性与便利性之间进行权衡。

Both drugs are high-cost biologic therapies, and long-term affordability and access remain important considerations in many healthcare systems.

这两种药物都是高成本的生物疗法，长期的可负担性和可及性在许多医疗系统中仍然是重要的考虑因素。

Final Conclusions

最终结论

The review concludes that both aflibercept and brolucizumab are effective and valuable options for treating diabetic macular edema. Aflibercept continues to serve as a reliable first-line therapy due to its strong evidence base and established safety record. Brolucizumab offers promising durability and potent anatomical effects, but its use requires careful patient selection and vigilant follow-up due to inflammatory risks.

综上所述，阿柏西普和布罗鲁珠单抗都是治疗糖尿病性黄斑水肿的有效且有价值的选项。由于其强大的证据基础和可靠的安全记录，阿柏西普仍然是值得信赖的一线疗法。布罗鲁珠单抗在持久性和解剖学效果方面表现出良好的潜力，但由于存在炎症风险，其使用需要谨慎选择患者并密切随访。

Ultimately, individualized treatment strategies that consider disease severity, prior response, patient lifestyle, and risk tolerance are essential for achieving optimal long-term visual outcomes in patients with diabetic retinal disease..

最终，考虑疾病严重程度、先前的治疗反应、患者生活方式和风险承受能力的个体化治疗策略，对于实现糖尿病视网膜病患者的最佳长期视力结果至关重要。

The study findings were published in the peer reviewed journal: Biomedicines.

研究结果发表在同行评审期刊《生物医学》上。

https://www.mdpi.com/2227-9059/14/3/501

For the latest Diabetic Macular Edema, keep on logging to Thailand

对于最新的糖尿病性黄斑水肿，继续登录到泰国。

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