Clinical outcomes of 1 + PRN and 3 + Q3M regimens of intravitreal conbercept injection for exudative age-related macular degeneration

Abstract

This retrospective study aimed to analyze the clinical outcomes of two regimens of intravitreal injections of conbercept [1+pro re nata (PRN) and 3 + Q3M] for the therapy of exudative age-related macular degeneration (AMD). In total, 105 eyes diagnosed with exudative AMD were enrolled. The eyes in the 1+PRN group (n = 51) received intravitreal injection of conbercept one time, followed by PRN retreatment. The eyes in the 3 + Q3M group (n = 54) received intravitreal injection of conbercept on three consecutive monthly, subsequently, once every three months for three times. After treatment, patients were followed up for 12 months. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), and choroidal neovascularization (CNV) leakage area were compared before and after treatment. Moreover, the number of injections and adverse reactions were recorded. Compared with the 1+PRN group, BCVA was significantly improved and CRT was remarkably decreased in the 3 + Q3M group at 3, 6 and 12 months after operation. The disappeared or reduced CNV leakage area (93%) of the 3 + Q3M group was higher than that of the 1 + PRN group at the last follow-up. Moreover, the mean numbers of conbercept injections of the 1 + PRN group were less than the 3 + Q3M group. During the follow-up, there were no serious adverse reactions or ocular complications. This study reveals that intravitreal injection of conbercept using 3 + Q3M regimen has certain advantages than 1 + pRn regimen in extending drug delivery interval, improving patient's vision, and reducing CRT. Age-related macular degeneration (AMD) is one of the major causes of irreversible blindness in the elderly in the developing world 1,2. It is estimated that the prevalence of AMD among people 55 years of age and older is around 8.7% in the world 3 , and will increase in the near future since the proportion of the population over 65 years of age in developed countries is predicted to rise dramatically 4. AMD can be divided into non-exudative and exudative types, which are also known as dry or non-neovascular and wet or neovascular AMD. Although only about 10% of AMD patients have the exudative form, the incidence of severe vision impairment and blindness is as high as 80%-90% 5. One of the pathological mechanisms of exudative AMD-caused visual loss is the presence of choroidal neovascularization (CNV), the formation of aberrant new vessels arising from pre-existing choroidal 6-8. It is reported that vascular endothelial growth factor (VEGF) is a crucial regulator in CNV formation 9 and is identified as the main target for exudative AMD treatment 10. Large-scale clinical trials have confirmed that intravitreal injection of VEGF antagonists can prevent or improve vision loss in patients with exudative AMD 11-13. Conbercept (KH902; Chengdu Kanghong Biotech Co., Ltd., Sichuan, China) is the first independently developed anti-VEGF drug in China, which is a fusion protein consisting of the VEGF binding domains of VEGF receptor 1 and 2 combined with the Fc portion of the human i...

Factors for Visual Acuity Improvement After Anti-VEGF Treatment of Wet Age-Related Macular Degeneration in China: 12 Months Follow up

“…However, in China, these two anti-VEGF drugs were not approved by health insurance for use in patients with wAMD until May 2019. Prior to this date, the large cost of high-priced drugs greatly affected the patient's treatment compliance and compromised data integrity ( 32 , 33 ). Therefore, the anti-VEGF treatment regimen and its efficacy in wAMD patients in China before 2019 were different from the data reported worldwide.…”

Clinical efficacy and changes of serum VEGF-A, VEGF-B, and PLGF after conbercept treating neovascular age-related macular degeneration

“…The BCVA was evaluated at baseline and at 1, 3, and 12mo after the intravitreal injection. The BCVA was assess by The Early Treatment Diabetic Retinopathy Study (ETDRS) vision acuity chart at four meters of distance [13] . Central Retinal Thickness The CRT between the macular fovea to the Bruch membrane was detected by optical coherence tomography (OCT; Heidelberg, Germany) at baseline and 1, 3, and 12mo after conbercept treatment.…”

“…Conbercept is an anti-VEGF agent which was manufactured by Chengdu Kanghong Biotech Co., Ltd., China. It is an engineered fusion protein yielded by the gene recombination of VEGF receptor (VEGFR)-1 and VEGFR-2 with the Fc fragment of human immunoglobulin, which can bind VEGF-A, VEGF-B, and placental growth factor (PLGF) and has successfully improved best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in the patients with CNV [12][13][14] . It was reported that conbercept significantly decreased serum VEGF levels at one day and one week after treatment, and this side effect did not sustain for one month [15] .…”

Neutrophil extracellular traps boost laser‐induced mouse choroidal neovascularization through the activation of the choroidal endothelial cell TLR4/HIF‐1α pathway

“…The patients with nAMD, which is featured by choroidal neovascularization (CNV), lead to severe and fast vision impairment. Intravitreal injection of anti‐vascular endothelial growth factor (VEGF) agents, such as conbercept [4], have been generally and effectively used worldwide in the clinical treatment of nAMD via targeting CNV. It has been revealed that anti‐VEGF therapy improves vision and quality of life for nAMD patients [5].…”