Comparison of Time to Retreatment and Visual Function Between Ranibizumab and Aflibercept in Age-Related Macular Degeneration

Inoue, Maiko; Yamane, Shin; Sato, Shimpei; Sakamaki, Kentaro; Arakawa, Akira; Kadonosono, Kazuaki

doi:10.1016/j.ajo.2016.06.021

Cited by 26 publications

(15 citation statements)

References 22 publications

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“…The data showed that approximately 63%, 38%, and 19% of the treatment-naïve AMD eyes did not require additional aflibercept injections during the following 3, 6, and 12 months of treatment, respectively (Figure 1C). Using Kaplan–Meier survival analyses, the eyes treated with ranibizumab were shown to relapse earlier than the aflibercept-treated eyes, but the overall recurrence percentage was not statistically different between these drug groups as reported recently by Inoue et al,17 and more than 80% of the treated eyes experienced a recurrence within 1 year. Thus, with the use of aflibercept, more than 80% of the patients needed additional injections within 1 year, and approximately half of the patients needed proactive treatment due to either a poor response or dependence.…”

Section: Discussionsupporting

confidence: 66%

Response of eyes with age-related macular degeneration to anti-VEGF drugs and implications for therapy planning

Miyamoto

Mandai

Kojima

et al. 2017

OPTH

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PurposeTo evaluate the response to and dependence on aflibercept or ranibizumab in patients with age-related macular degeneration (AMD).MethodsWe retrospectively reviewed AMD patients who received induction therapy with aflibercept or ranibizumab for the following parameters: whether complete resolution of the retinal fluid (“good response”) was achieved and whether recurrence was observed within 3 months (“dependent”) after the induction treatment. With aflibercept treatment, treatment-naïve eyes with a good response/non-dependence were recommended a pro re nata regimen, and other eyes were recommended a proactive bimonthly regimen, followed by monitoring of visual acuity (VA) for 12 months. The measured values of the groups were compared using one-way analysis of variance with Tukey’s test to evaluate the difference between baseline and postinjection VA.ResultsAmong the treatment-naïve eyes, 76% had a good response to aflibercept and 37% of these were aflibercept-dependent, while 58% had a good response to ranibizumab but 51% of these were ranibizumab-dependent. Among the eyes that converted from ranibizumab treatment, 92% of the good responders to ranibizumab with dependence and 76% of the poor responders on ranibizumab had a good response to aflibercept. With aflibercept treatment, the mean VA of treatment-naïve patients was significantly better than the baseline VA over 12 months (P<0.001), and the VA of the converted group improved significantly with proactive treatment and the improvement was continuously maintained from 6 to 12 months.ConclusionThe evaluation of response to and dependence on anti-vascular endothelial growth factor therapies in AMD was useful and practical in managing therapeutic protocols to obtain a good VA.

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Section: Discussionsupporting

confidence: 66%

Response of eyes with age-related macular degeneration to anti-VEGF drugs and implications for therapy planning

Miyamoto

Mandai

Kojima

et al. 2017

OPTH

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“…Finally, another recent study from Japan examined the time to retreatment with ranibizumab compared to aflibercept after 3 consecutive monthly injections, using a pro re nata regimen in the maintenance phase for both treatments [27] . Both drugs had the same median time to retreatment (5 months) and similar rates of requiring any injections in the maintenance phase up to 1 year.…”

Section: Discussionmentioning

confidence: 99%

One-Year Outcomes of a Treat-and-Extend Regimen of Aflibercept for Exudative Age-Related Macular Degeneration

Yamamoto

Okada²,

Nakayama³

et al. 2017

Ophthalmologica

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Purpose: The aim of this study was to investigate the 1-year outcomes of treat-and-extend aflibercept for exudative age-related macular degeneration (AMD) in Japan. Procedures: Clinical records of 67 patients (67 eyes) were reviewed. Monthly aflibercept was administered until resolution of exudation and maximal reduction of pigment epithelial detachment. Injection intervals were extended by 2-week units up to 12 weeks if no exudation was observed and shortened for recurrence. Results: Mean best-corrected visual acuity (logarithm of the minimum angle of resolution) improved from 0.29 to 0.14 at 12 months (p < 0.0001). Mean central retinal thickness decreased from 430 μm to 236 μm at 12 months (p < 0.0001). Fifty-nine eyes (88.0%) achieved a dry macula with a mean of 8.3 injections by study end. The injection interval was extended to 10 weeks in 44.8% and to 12 weeks in 17.9% of eyes. Conclusions: At 1 year, good outcomes were obtained using treat-and-extend aflibercept for exudative AMD in Japan.

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“…(Continued ) Similarly Inoue et al, looked at a cohort of 101 patients and demonstrated an improvement in BCVA from 0.37 logMAR to 0.25 logMAR. The study also showed that 63.5% of patients needed re-treatment and 36.5% of patients did not need further treatment 30. …”

mentioning

confidence: 74%

“…A comparative study by Inoue et al, compared between PRN ranibizumab and aflibercept and found that although both groups showed a significant improvement from baseline, there was no difference between the visual improvements between both drugs. 30 In addition, the mean time to retreatment was 5 months in both groups. Similar number of patients required retreatment in both groups (67.7 in the ranibizumab group vs 63.4% in the aflibercept group).…”

Section: Aflibercept Vs Ranibizumabmentioning

confidence: 91%

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Aflibercept in age-related macular degeneration: evaluating its role as a primary therapeutic option

Ashraf

Souka

2017

Eye

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The recent VIEW studies have demonstrated the non-inferiority of monthly and bi-monthly aflibercept in the management of wet age related macular degeneration (AMD) compared with ranibizumab. However, the current data are limited mainly to fixed dosing regimens with few studies looking at flexible dosing regimens of aflibercept in wet AMD. In addition, recent data from the VIEW 96 week extension has shown that patients being shifted from fixed dosing regimens to PRN have shown a drop in visual acuity and increase in central macular thickness. This is an indication that fixed dosing, a non-sustainable option, is only effective as long as it is continued. Regimens such as treat and extend (TAE) and pro-re nata (PRN) have been studied extensively in ranibizumab and bevacizumab and have shown to be effective options. With the presence of effective, established and less costly drugs such as ranibizumab and bevacizumab, the role of aflibercept as a primary treatment modality has yet to be clearly defined. The current review provides an analysis of the VIEW studies, as well as the extension phases. It also looks at post hoc analysis of predictors of response and outcomes. We have also conducted a search on studies comparing between PRN regimens using aflibercept and other anti-VEGF agents. This review also explores cheaper off label aflibercept; ziv-aflibercept in the treatment of wet AMD. The main purpose of the review is to delineate the role of aflibercept as a primary therapeutic option and if there are any significant advantages that would advocate its use over alternative anti-VEGF drugs. Finally, we propose a treatment algorithm for patients being started on aflibercept during the first year and thereafter.

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Comparison of Time to Retreatment and Visual Function Between Ranibizumab and Aflibercept in Age-Related Macular Degeneration

Cited by 26 publications

References 22 publications

Response of eyes with age-related macular degeneration to anti-VEGF drugs and implications for therapy planning

Response of eyes with age-related macular degeneration to anti-VEGF drugs and implications for therapy planning

One-Year Outcomes of a Treat-and-Extend Regimen of Aflibercept for Exudative Age-Related Macular Degeneration

Aflibercept in age-related macular degeneration: evaluating its role as a primary therapeutic option

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