Researchers in the US and Brazil have found that a cheap oral inflammasome inhibitor, commonly prescribed for patients with HIV, significantly improved vision in patients with centre-involved diabetic macular oedema (CI-DMO). 

Writing in Med, the researchers reported that 24 patients with CI-DMO were randomised to receive either lamivudine (150 mg twice daily) or placebo for eight weeks. At four weeks, best corrected visual acuity (BCVA) improved by 9.8 letters with lamivudine and decreased by 1.8 letters with placebo (p < 0.001). At eight weeks, BCVA improved by 16.9 letters with lamivudine plus bevacizumab, compared with 5.3 letters with placebo plus bevacizumab (p < 0.001). 

Lamivudine was associated with greater BCVA improvement than anti-VEGF injections with bevacizumab or ranibizumab (p < 0.05), and outcomes were not significantly different from aflibercept (p = 0.5). No significant differences in retinal thickness or adverse events were observed between groups, according to the authors. 

At just US$20 a month, lamivudine could be a game changer for patients with DMO, said senior researcher Dr Jayakrishna Ambati, founding director of the University of Virginia Health’s Center for Advanced Vision Science. “It would [also] be more convenient for patients than frequent, often monthly [anti-VEGF] injections into the eye,” he said.