Eylea vs Vabysmo for Diabetic Macular Edema (DME): A Comparative Guide

A detailed comparison of the extended-release eye injections Eylea and Vabysmo. Which is better for your condition? And the number of doses required, with Dr. Mahmoud Hassan at Mashreq Eye Center.

The Difference Between Eylea vs Vabysmo Injections for Diabetic Retinal Edema: An In-Depth Look by Dr. Mahmoud Hassan

Diabetic retinal edema, also known as Diabetic Macular Edema (DME), is a serious complication of diabetes that directly threatens vision. Prolonged high blood sugar levels damage the delicate blood vessels in the retina, leading to leakage of fluid and blood into the central area of the retina responsible for detailed vision (the macula). This leakage causes swelling (edema) which leads to blurred vision, difficulty reading, and the appearance of dark spots in the field of vision. Fortunately, the field of ophthalmology has witnessed tremendous developments in treatment methods, and among the most prominent of these developments is the emergence of innovative eye injections that aim to stop this leakage and improve vision. In this article, we review the difference between two of the most prominent of these modern treatments: Eylea injections and Vabysmo injections, highlighting their mechanism of action, efficacy, and the considerations that Dr. Mahmoud Hassan, a retina and vitreous surgeon, takes into account when choosing the most appropriate treatment for his patients at Al Mashreq Eye Center in Cairo.

Mechanism of Action of Eylea and Vabysmo Injections

The primary similarity between Eylea and Vabysmo lies in their mechanism of action, which targets vascular endothelial growth factor (VEGF). VEGF is a protein that plays a key role in the formation of new blood vessels (angiogenesis) and increasing the permeability of existing blood vessels. In diabetic retinal edema, VEGF levels rise excessively, leading to fluid leakage from abnormal blood vessels and worsening macular edema.

Eylea Injections: Targeting VEGF-A

Eylea (aflibercept) acts as a potent inhibitor of VEGF-A. Eylea binds to VEGF-A, preventing it from binding to its receptors on endothelial cells of blood vessels, thereby reducing blood vessel permeability and limiting the growth of abnormal vessels. Clinical studies have demonstrated Eylea's effectiveness in improving visual acuity and reducing retinal thickness in many patients with diabetic retinal edema, making it a popular and effective treatment option.

Vabysmo Injections: Dual Targeting of VEGF-A and Ang-2

Vabysmo (faricimab) represents a significant advancement in this field, as it is the first approved treatment that targets two main pathways responsible for abnormal blood vessel growth and increased permeability. In addition to inhibiting VEGF-A, Vabysmo also inhibits another protein called Angiopoietin-2 (Ang-2). Ang-2 is believed to play a role in blood vessel instability and inflammation exacerbation, and its inhibition in combination with VEGF-A provides a stronger synergistic effect.

Scientifically, targeting Ang-2 may help achieve longer blood vessel stabilization and more effectively reduce inflammation, potentially leading to improved long-term outcomes and reducing the need for frequent injections compared to VEGF-only targeted therapies.

Comparison of Efficacy and Dosage

When comparing Eylea and Vabysmo in the treatment of diabetic retinal edema, results show that both are highly effective in improving vision and reducing edema. However, there are some differences that may be crucial in choosing the most appropriate treatment:

• Efficacy: Studies have shown that both drugs achieve significant improvements in visual acuity and reduction of macular edema. In some comparative studies, Vabysmo has been observed to provide similar or even slightly better improvements in some measures, especially regarding long-term condition stability, due to its dual mechanism of action.
• Dosage and Injection Frequency: Eylea is typically administered as a monthly injection initially, then the frequency can be reduced to one injection every two months or more based on the patient's response and the doctor's assessment. As for Vabysmo, clinical trials have shown its ability to provide effective disease control with doses every two months, and in some cases, the interval between injections can be extended to every four months after stability is achieved, which reduces the burden on the patient and improves treatment adherence.
• Tolerability and Safety: Both drugs are generally considered safe when used under specialized medical supervision. The most common side effects include mild pain or redness at the injection site, and a temporary increase in eye pressure. Serious side effects are very rare but possible, including endophthalmitis or retinal detachment.

When Does Dr. Mahmoud Hassan Opt for Eylea and When Does He Prefer Vabysmo?

The decision to choose between Eylea and Vabysmo therapies depends on a comprehensive assessment of each patient's condition. Dr. Mahmoud Hassan, vitreoretinal surgeon at Al Mashreq Eye Center, states: "Each medication has its advantages, and the choice depends on multiple factors including the severity of the condition, its progression rate, the patient's response to previous treatments if any, and the patient's lifestyle and preferences regarding the frequency of clinic visits."

Dr. Hassan may prefer to use Eylea in the following cases:

• When the patient has responded well to similar other treatments in the past.
• In cases requiring rapid and effective intervention to reduce fluid leakage.
• If the patient prefers a long-established treatment protocol with a proven track record of results.

Conversely, Dr. Hassan may lean towards Vabysmo in the following cases:

• For patients seeking a treatment option that may reduce the number of injections required in the long term, offering greater convenience and improving adherence.
• In cases where inflammation may be a contributing factor to the worsening of macular edema, given Vabysmo's ability to target Ang-2.
• For patients who have not responded adequately to previous treatments targeting only VEGF.

It is important to note that both treatments require precise periodic follow-up using advanced examinations such as Optical Coherence Tomography (OCT) to assess treatment response and determine the need for subsequent doses. Understanding the difference between Eylea and Vabysmo injections for diabetic macular edema helps the patient make an informed decision in consultation with their doctor.

Treatment Cost

The cost of eye injections is an important factor that patients consider. The price of Eylea or Vabysmo injections in Egypt for 2026 varies based on several factors, including the type of injection, the treatment protocol followed, and insurance coverage if available. Generally, these injections are advanced treatments with relatively high costs. The price of intravitreal injections (IVI) in Egypt for 2026 starts from approximately 7,000 EGP (estimated), and the price of Eylea / Lucentis injections is approximately 9,000 EGP (estimated), while the price of Vabysmo injections is approximately 11,000 EGP (estimated). These prices are approximate and depend on the patient's condition and the doctor's recommendations. We always recommend contacting the center directly for precise details.

Conclusion

Both Eylea and Vabysmo represent powerful tools in our fight against diabetic macular edema. The choice between them is not a simple decision, but requires medical expertise and a precise assessment of each patient's condition. At Al Mashreq Eye Center, we are committed to providing the latest technologies and the best care for our patients, under the supervision of elite specialized doctors. If you suffer from symptoms of diabetic macular edema or any other vision problems, do not hesitate to consult the experts. You can find more valuable information and tips about eye health here.

For bookings and inquiries: 01002310813

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