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Biosimilar anti-VEGF agents show comparable visual outcomes and safety to reference anti-VEGF agentsBiosimilar drugs show similar results for several retinal diseases

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Key Takeaway
Note that biosimilar anti-VEGF agents provide comparable visual outcomes and safety to reference anti-VEGF agents.

This systematic review and meta-analysis evaluates the efficacy and safety of biosimilar anti-VEGF agents compared to reference anti-VEGF agents in patients with neovascular age-related macular degeneration, diabetic macular edema, retinal vein occlusion, and polypoidal choroidal vasculopathy. The analysis synthesized data on primary and secondary outcomes, including final visual acuity, change in visual acuity, final retinal thickness, and change in retinal thickness.

The meta-analysis found no significant differences between biosimilar and reference anti-VEGF agents across all measured outcomes. Specifically, no significant differences were reported for final visual acuity, change in visual acuity, final retinal thickness, or change in retinal thickness. Furthermore, the incidence of adverse events showed no significant differences between the two groups.

Authors noted limitations including the need for more diverse patient populations and the requirement for standardized, extended follow-up periods. The evidence is of moderate to high certainty. These findings suggest that biosimilar anti-VEGF agents are comparable to reference products regarding safety profiles and visual outcomes in the management of these retinal conditions.

How this fits prior evidence

This meta-analysis addresses a gap in the clinical comparison of biosimilar versus reference products for retinal diseases. It complements previous evidence showing that intravitreal ranibizumab improves visual acuity and reduces macular thickness more than laser photocoagulation, and that ranibizumab port delivery systems provide noninferior BCVA gains. While previous reports established the efficacy of specific ranibizumab formulations, this study confirms that the use of a biosimilar version of these agents provides comparable outcomes to the reference products.

Living with a retinal condition like age-related macular degeneration or diabetic macular edema can be frightening. These conditions can threaten your vision, making it vital to have reliable treatments. A large review of data looked at how biosimilar drugs compare to the original brand-name versions for these specific eye issues.

Researchers looked at several conditions, including retinal vein occlusion and polypoidal choroidal vasculopathy. They compared the results of biosimilar anti-VEGF drugs against the reference drugs. The study found no significant differences in final vision, the change in vision, or the thickness of the retina. This means the biosimilar versions performed similarly to the brand-name drugs in these tests.

Safety was also a key focus. The study found no significant differences in the number of adverse events between the two types of drugs. While the study notes that more diverse patients and longer follow-up periods would provide even more clarity, the current evidence shows these drugs are comparable in both safety and vision outcomes.

What this means for you:
Biosimilar drugs show similar safety and vision results compared to brand-name drugs for several retinal conditions.

Common questions

Are biosimilar drugs as safe as brand-name drugs for my eyes?

Yes, the study found no significant differences in the incidence of adverse events between biosimilar anti-VEGF drugs and the brand-name reference drugs. This means both types of medication showed a similar safety profile for patients with retinal diseases like macular degeneration or retinal vein occlusion.

Will a biosimilar drug affect my vision differently than the original?

The data showed no significant differences in final visual acuity or the change in visual acuity when comparing biosimilars to reference drugs. Additionally, there were no significant differences in retinal thickness. These findings suggest that both types of drugs provide similar vision outcomes.

What specific eye conditions are these drugs used for?

These drugs are used to treat several conditions that affect the back of the eye. This includes neovascular age-related macular degeneration, diabetic macular edema, retinal vein occlusion, and polypoidal choroidal vasculopathy.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up14.7 mo
PublishedOct 2026
View Original Abstract ↓
PURPOSE: To evaluate the comparative effectiveness and safety of biosimilar antivascular endothelial growth factor (VEGF) versus reference anti-VEGF intravitreal injections for the treatment of retinal diseases. METHODS: A systematic review and meta-analysis was performed on studies identified through searches of Ovid MEDLINE, Embase, and the Cochrane Library between January 2015 and September 2024. Studies evaluating effectiveness and/or safety outcomes of biosimilar anti-VEGF were included. Meta-analysis was performed with a random-effects model. Risk of bias assessment was performed with the Joanna Briggs Institute tools, and certainty of evidence was evaluated with the Grading of Recommendations, Assessment, Development, and Evaluation criteria. RESULTS: A total of 25 studies were included in the meta-analysis. Diagnoses studied were neovascular age-related macular degeneration, diabetic macular edema, retinal vein occlusion, and polypoidal choroidal vasculopathy. There were no significant differences in final visual acuity, change in visual acuity, final retinal thickness, change in retinal thickness, and incidence of adverse events over a follow-up duration of 12 to 63.6 weeks. Subgroup analyses of randomized controlled trials, observational studies, age-related macular degeneration, diabetic macular edema, and agent-specific analysis (aflibercept and ranibizumab) were not significant. Findings are supported by evidence of moderate to high certainty as per the Grading of Recommendations, Assessment, Development, and Evaluation tool. There was a low to moderate risk of bias in the included study as per the Joanna Briggs Institute tools. CONCLUSION: Biosimilar anti-VEGF is comparable with reference anti-VEGF regarding safety profile and visual outcomes. Future research should prioritize including diverse patient populations and adopting standardized, extended follow-up periods to enhance the assessment of long-term safety and effectiveness of biosimilars.
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