{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:10:33Z","timestamp":1788441033328,"version":"build-2803163510"},"reference-count":5,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006453","name":"Taisho Toyama Pharmaceutical Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To evaluate the feasibility of sodium\u2010glucose cotransporter 2 inhibitors (SGLT2i) as a systemic adjunct for patients with diabetic macular edema (DME) and hypertension.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n This study encompassed a post hoc analysis of the COMET Trial data, focusing on patients with DME and hypertension, defined by office systolic blood pressure (OSBP) \u2265\u2009140\u2009mmHg or a documented history of hypertension. Participants were randomized to receive either SGLT2i (luseogliflozin) or sulfonylurea (SU, glimepiride). The primary outcome was the treatment burden, quantified by the total number of intravitreal ranibizumab injections (IVRs) over 48\u2009weeks.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Within the OSBP \u2265\u2009140\u2009mmHg subgroup, 14 patients received SGLT2i and 15 received SU. The total number of IVRs was 4.1\u2009\u00b1\u20093.1 in the SGLT2i group and 6.8\u2009\u00b1\u20093.1 in the SU group (Cohen's\n d<\/jats:italic>\n \u2009=\u20090.87; power\u2009=\u20090.82). The adjusted analysis of covariance further confirmed significantly fewer IVRs in the SGLT2i group (3.3\u2009\u00b1\u20091.1 vs. 6.2\u2009\u00b1\u20091.0,\n p<\/jats:italic>\n \u2009=\u20090.025). OSBP was significantly reduced in the SGLT2i group at Week 12, but there was no significant difference at Week 48. Office diastolic blood pressure remained consistently lower in the SGLT2i group. No significant differences in IVR frequency were observed in other subgroups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n SGLT2i may help reduce the treatment burden of IVRs in patients with DME and elevated OSBP. The improvements in blood pressure and visual acuity, despite fewer injections, indicate a potential synergistic effect of SGLT2i in managing DME with hypertension. Further investigation is warranted to validate its efficacy as a potential systemic adjunct.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n UMIN000057674.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1753-0407.70184","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T06:57:02Z","timestamp":1766127422000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Blood Pressure Status Modulates the Therapeutic Response to Sodium\u2010Glucose Cotransporter 2 Inhibitors in Diabetic Macular Edema: A Post Hoc Subgroup Analysis of the\n COMET<\/scp>\n Trial"],"prefix":"10.1111","volume":"17","author":[{"given":"Ryoichi","family":"Ishibashi","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Diabetes, Endocrinology and Metabolism Kimitsu Chuo Hospital Chiba Japan"},{"name":"Department of Endocrinology, Haematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7374-9993","authenticated-orcid":false,"given":"Masaya","family":"Koshizaka","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Haematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan"},{"name":"Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences Chiba University Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1209-0934","authenticated-orcid":false,"given":"Yoko","family":"Takatsuna","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Chiba Rosai Hospital Chiba Japan"},{"name":"Department of Ophthalmology and Vision Science Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8271-9403","authenticated-orcid":false,"given":"Tomoaki","family":"Tatsumi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koutaro","family":"Yokote","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Haematology and Gerontology Chiba University Graduate School of Medicine Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_2_1_13_2_1","article-title":"Blood Pressure Control for Diabetic Retinopathy","volume":"3","author":"Do D. V.","year":"2023","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_1_13_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1601633"},{"key":"e_1_2_1_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16244"},{"key":"e_1_2_1_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16478"},{"key":"e_1_2_1_13_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/db22-0970"}],"container-title":["Journal of Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1753-0407.70184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T09:19:11Z","timestamp":1766481551000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1753-0407.70184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":5,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/1753-0407.70184"],"URL":"https:\/\/doi.org\/10.1111\/1753-0407.70184","archive":["Portico"],"relation":{},"ISSN":["1753-0393","1753-0407"],"issn-type":[{"value":"1753-0393","type":"print"},{"value":"1753-0407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70184"}}