Treatment strategies in proliferative diabetic retinopathy (PDR) often involve intravitreal therapy or panretinal photocoagulation (PRP). The CONDOR trial (Study of Efficacy and Safety of Brolucizumab Versus Panretinal Photocoagulation Laser in Patients With Proliferative Diabetic Retinopathy), published in JAMA Ophthalmology, evaluated the efficacy and safety of brolucizumab compared with PRP.

CONDOR was a 96-week, company-sponsored, phase 3, single-masked, multicenter randomized clinical trial conducted across 152 sites in 16 countries. Data were analyzed from December 4, 2020, to October 30, 2023. A total of 689 participants with diabetes and treatment-naïve PDR were randomized 1:1 to brolucizumab 6 mg (n=347) or panretinal photocoagulation (n=342). Brolucizumab was administered every 6 weeks for three loading doses, followed by every 12 weeks. From week 48, treatment intervals could be extended in 6-week increments up to 24 weeks based on disease activity. PRP was delivered in 1 to 4 sessions through week 12, with additional treatment as needed.

The primary outcome was change in best-corrected visual acuity (BCVA) at week 54. Secondary outcomes included diabetic retinopathy progression, prevention of center-involved diabetic macular edema, changes in Diabetic Retinopathy Severity Score levels, and safety.

Baseline mean age was 53.9 years, 40.1% of participants were female, and mean BCVA was 77.1 letters (Snellen equivalent 20/32). At week 54, 572 participants completed follow-up. Brolucizumab met both noninferiority and superiority criteria for BCVA change. Mean letter score change was 0.2 with brolucizumab versus −4.2 with PRP, corresponding to a difference of 4.4 letters (95% CI, 2.4–6.4; P<.001).

A higher proportion of patients receiving brolucizumab had no PDR at week 54 compared with PRP (63.6% vs 22.4%; difference, 39.4%; 95% CI, 32.0–46.8; P<.001). Ocular adverse events were reported in 34.3% and 49.1% of patients, respectively. Intraocular inflammation, including retinal vasculitis, occurred more frequently with brolucizumab (5.2% vs 0.6%).

These findings indicate that brolucizumab provided superior visual acuity outcomes and higher rates of disease regression compared with PRP, with a higher incidence of intraocular inflammation observed.