Iluvien (190µg fluocinolone acetonide (FAc) intravitreal implant in applicator) is being made available in Ireland following an agreement between the healthcare provider Vhi and Iluvien’s manufacturer Alimera Sciences.
luvien is an implant injected into the affected eye and lasts up to 3 years, providing a continuous daily microdose of the corticosteroid FAc. Results from an ongoing audit of real-life UK clinical practice published in Eye in July 2017 show 86.7% of patients maintained or gained vision 24 months after receiving a single Iluvien implant. These results are comparable to the pivotal Iluvien phase 3 clinical trials (FAME), despite patients from this audit having received more prior intravitreal treatments and hence their disease was likely to have been more chronic.
In the Republic of Ireland, Iluvien is indicated for the treatment of visual impairment in patients with chronic DME insufficiently responsive to available therapies. Current first-line treatment options for DME include intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatments, which usually require regular intravitreal injections. Unfortunately, recent real-world practice studies show that intravitreal anti-VEGF injection frequency is lower than reported in pivotal randomised clinical trials and in a significant proportion of patients may be associated with sub-optimal visual acuity (VA) outcomes.
In patients who have an insufficient response to first-line therapy, a single Iluvien implant will provide patients who have Vhi medical insurance cover with a new treatment option, enabling their ophthalmologist to treat DME in a different way through continuous microdosing with FAc for up to three years. As well as the potential patient clinical benefits, real-world experience with Iluvien in other countries has shown a reduction in number of intravitreal injections that the patient needs, thereby reducing the number of visits to hospital, which in turn serves to free up clinic capacity within hospital eye services.
“Diabetes and its related complications can have a serious impact on a person’s health and quality of life. Effective means of controlling DME to prevent widespread vision loss is a growing need amongst some diabetic patients," Dr. Bernadette Carr, Medical Director, Vhi, said in a news release. "Vhi is committed to diabetes care. We have carried out the largest screening program for type 2 diabetes, screening more than 30,000 Vhi members in Ireland and found that up to 24,000 people could have undiagnosed diabetes. This comprehensive piece of research provides valuable insights into likely complications our health service and the Irish population will face. Vhi is making this implant available to its members to highlight our commitment to supporting patients with diabetes.”