On February 16, Charles C. Wykoff, MD, PhD, announced to the American Academy of Ophthalmology annual meeting that Iluviuan (fluocinolone acetonide) treatment, after 1.3 injections over 3 years in the FAME trials, “significantly reduced progression to prolific diabetic retinopathy from 31% to 17%, a similar reduction as observed with monthly anti-VEGF treatments.”
Iluvian (Alimera Sciences) is a drug implant devised for treatment of diabetic macular edema (DME). It is a corticosteroid that has demonstrated effectiveness in the treatment of DME without the need for monthly injections. Tiny implants injected into the eye’s vitreous gel release the steroids into the retina over a period of years, greatly relieving the burden of multiple clinic visits.
In November 2017, Jay Prensky, MD reported to the American Society of Retina Specialists that Iluviuan provided study subjects with anatomic and visual improvements at the 6-month evaluation in a phase IV study of the implant’s efficacy, anatomic, and safety outcomes.
Patients with the worst baseline vision had the greatest improvements compared with those with better initial vision, with best corrected visual acuity improving significantly beginning as early as 7 days after the implant and sustaining out to the 6-month time point. Additionally, concurrent decreases in the central subfield thickness were seen early after implantation and remained decreased to the 6-month evaluation.
Due to the high risk of cataract development and glaucoma, extended-release steroid treatments are limited to adults without elevated intraocular pressure and those who either have undergone, or are scheduled for, cataract surgery.
Iluvian is also being studied as a treatment for dry AMD, but concerns by the FDA about safety and manufacturing standards have slowed its progress toward clinical trials.