Effectiveness of Biosimilar Ranibizumab in the Management of Diabetic Macular Edema (ERBDME)

June 17, 2026 updated by: Ehab Mohamed Elsayed Mohamed Saad, Benha University

Effectiveness of Biosimilar Ranibizumab in the Management of Diabetic Macular Edema: A Retrospective Observational Cohort Study

Diabetic macular edema (DME) is a leading cause of vision loss in patients with diabetes. Anti-VEGF agents are widely used to improve vision and reduce retinal swelling. However, treatment cost remains a major barrier in many healthcare systems.

This study evaluates the real-world effectiveness and safety of a ranibizumab biosimilar in patients with DME. Medical records of adult patients treated at a tertiary ophthalmology center will be reviewed. Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) will be analyzed from baseline to final follow-up, along with treatment burden and safety outcomes.

The findings aim to provide evidence on visual and anatomical outcomes following biosimilar anti-VEGF therapy in routine clinical practice.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study is a retrospective observational cohort designed to evaluate the real-world effectiveness and safety of intravitreal ranibizumab biosimilar in patients with diabetic macular edema (DME). Medical records of adult patients diagnosed with type 1 or type 2 diabetes mellitus who received at least one injection of ranibizumab biosimilar at the Retina Unit, Department of Ophthalmology, Benha University Hospitals, between January 2022 and April 2026 will be reviewed. Eligible cases will include eyes with center-involving DME confirmed by optical coherence tomography (OCT) and a minimum follow-up period of 3-6 months. Baseline demographic, systemic, and ocular characteristics, including age, sex, diabetes duration, HbA1c level, lens status, prior ocular treatment, best-corrected visual acuity (BCVA), and central macular thickness (CMT), will be collected. Follow-up data will include changes in BCVA and CMT, number of injections received, and treatment regimen (loading dose, pro re nata, or treat-and-extend protocols). Outcomes will assess mean changes in BCVA and CMT from baseline to final follow-up, as well as the proportion of eyes achieving clinically meaningful visual and anatomical improvement. Safety outcomes will include ocular adverse events such as endophthalmitis, intraocular inflammation, retinal detachment, and intraocular pressure elevation, as well as systemic thromboembolic events. Statistical analysis will be performed using SPSS software, with appropriate parametric or non-parametric tests applied based on data distribution, and a p-value <0.05 considered statistically significant. The study will be conducted following Institutional Review Board approval and in accordance with the Declaration of Helsinki, with all data anonymized to ensure patient confidentiality.

Study Type

Observational

Enrollment (Actual)

60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
    • Benha
      • Banhā, Benha, Egypt, 13111
        • Benha University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Adult patients with type 1 or type 2 diabetes mellitus diagnosed with center-involving diabetic macular edema confirmed by optical coherence tomography (OCT), who received at least one intravitreal injection of ranibizumab biosimilar at the Retina Unit, Department of Ophthalmology, Benha University Hospitals, between January 2022 and April 2026. Eligible eyes had a minimum follow-up duration of 3-6 months with available baseline and follow-up data for best-corrected visual acuity (BCVA) and central macular thickness (CMT). Patients with other causes of macular edema, prior recent anti-VEGF therapy within the washout period, significant media opacity affecting imaging, coexisting retinal pathology affecting vision, prior vitreoretinal surgery, or incomplete records were excluded. The population reflects a real-world retrospective cohort treated in routine clinical practice.

Description

Inclusion Criteria:

  • • Age ≥18 years

    • Diagnosis of type 1 or type 2 diabetes mellitus
    • Center-involving diabetic macular edema confirmed by OCT
    • Received at least one intravitreal ranibizumab biosimilar injection
    • Minimum follow-up duration of 3-6 months

Exclusion Criteria:

  • • Macular edema due to causes other than diabetes

    • Prior anti-VEGF treatment within specified washout period
    • Significant media opacity affecting imaging
    • Coexisting retinal pathology affecting vision (e.g., AMD, RVO)
    • Prior vitreoretinal surgery
    • Incomplete records or inadequate follow-up

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Ranibizumab biosimilar treatment group
This cohort includes adult patients with type 1 or type 2 diabetes mellitus diagnosed with center-involving diabetic macular edema confirmed by optical coherence tomography (OCT), who received at least one intravitreal injection of ranibizumab biosimilar during the study period. All data are obtained retrospectively from medical records at the Retina Unit, Department of Ophthalmology, Benha University Hospitals. Patients were managed according to routine clinical practice using ranibizumab biosimilar administered via intravitreal injection, with treatment regimens including loading doses, pro re nata (PRN), or treat-and-extend (T&E) protocols as determined by the treating physician. No control or comparator group is included in this observational study. Outcomes of interest include changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), injection burden, and the incidence of ocular and systemic adverse events during follow-up.
Drug: Ranibizumab biosimilar
Intravitreal ranibizumab biosimilar administered as part of routine clinical care for the treatment of center-involving diabetic macular edema. Patients included in this retrospective cohort received at least one intravitreal injection of the biosimilar during the study period. Treatment regimens were determined by the treating physician and may have included an initial loading phase followed by pro re nata (PRN) or treat-and-extend (T&E) protocols based on disease activity assessed by clinical examination and optical coherence tomography (OCT). The intervention was not assigned by the investigators, and no randomization or experimental treatment allocation was performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in best-corrected visual acuity (BCVA)
Time Frame: Baseline to final follow-up (minimum 3-6 months)
Mean change in best-corrected visual acuity (BCVA) from baseline to the final follow-up visit after intravitreal ranibizumab biosimilar treatment in patients with diabetic macular edema. BCVA will be recorded in Snellen or converted to ETDRS equivalent letters where applicable, and compared between baseline and post-treatment measurements.
Baseline to final follow-up (minimum 3-6 months)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in central macular thickness (CMT)
Time Frame: Baseline to final follow-up (minimum 3-6 months)
Mean change in central macular thickness (CMT) measured by optical coherence tomography (OCT) from baseline to final follow-up after intravitreal ranibizumab biosimilar treatment in eyes with diabetic macular edema.
Baseline to final follow-up (minimum 3-6 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Benha University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2022

Primary Completion (Actual)

April 1, 2026

Study Completion (Actual)

April 15, 2026

Study Registration Dates

First Submitted

June 17, 2026

First Submitted That Met QC Criteria

June 17, 2026

First Posted (Actual)

June 23, 2026

Study Record Updates

Last Update Posted (Actual)

June 23, 2026

Last Update Submitted That Met QC Criteria

June 17, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • DME-RANIBIZUMAB-BIOSIMILAR-202

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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