Renal Safety of Intravitreal Ranibizumab and the Effects of SGLT2 Inhibition in Diabetic Macular Oedema: A Post Hoc Analysis of the COMET Trial
Authors' conclusion
No statistically significant exposure-response association was detected between cumulative IVR and renal markers within the COMET trial cohort and dosing range.
Study context
- Population
- Patients with diabetic macular oedema (DMO) receiving intravitreal ranibizumab in the COMET trialanalysed
- Participants
- 53 patients
- Comparison
- Cumulative intravitreal ranibizumab (IVR) exposure and renal markers; SGLT2 inhibitor effects
- Primary endpoint
- Association of cumulative IVR with eGFR, haematocrit and urinary albumin-to-creatinine ratio
- Follow-up
- 48 weeks
Methodological detailspost hoc sub-analysis, prospective, linear mixed-effects models
- Post hoc sub-analysis
- Prospective
- Linear mixed-effects models
Primary result
As reported in the abstract
Association of cumulative IVR with eGFR
Change in estimated glomerular filtration rate (eGFR) per IVR injection
−0.22 mL/min/1.73 m²
95% CI −0.59 to 0.15p = 0.25
Further findings
Baseline characteristics and IVR exposure
- Baseline eGFR (mean ± SD), mL/min/1.73 m²
- 72.2 ± 18.5
- Baseline median urinary albumin-to-creatinine ratio (UACR), mg/gCr
- 50.6
- Mean cumulative IVR at week 48 (± SD)
- 7.00 ± 4.42
SGLT2i effects
- The SGLT2 inhibitor reproduced an early eGFR dip and haematocrit (Hct) rise
Original publication
Renal Safety of Intravitreal Ranibizumab and the Effects of SGLT2 Inhibition in Diabetic Macular Oedema: A Post Hoc Analysis of the COMET Trial. Diabetes Obes Metab. Published 9 September 2026. doi:10.
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