Intravitreal Aflibercept (VEGF Trap-Eye) in Wet Age-related Macular Degeneration

Heier, Jeffrey S.; Brown, David M.; Chong, Victor; Korobelnik, J.-F.; Kaiser, Peter K.; Nguyen, Quan Dong; Kirchhof, Bernd; Ho, Allen C.; Ogura, Yuichiro; Yancopouloš, George D.; Stahl, Neil; Vitti, Robert; Berliner, Alyson J.; Soo, Yuhwen; Anderesi, Majid; Groetzbach, Georg; Sommerauer, Bernd; Sandbrink, Rupert; Simader, Christian; Schmidt‐Erfurth, Ursula

doi:10.1016/j.ophtha.2012.09.006

Cited by 2,072 publications

(1,797 citation statements)

References 20 publications

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“…16,17 It is now accepted that the best outcomes with anti-VEGF therapies in n-AMD are achieved with regular dosing at specific intervals, usually monthly, as demonstrated in the pivotal trials of ranibizumab, and sometimes two monthly in the first year with aflibercept after the ' three monthly initiation doses'. [22][23][24][25] Where this is not possible, treatment initiation with three initiation (or so called 'loading') doses at monthly intervals followed by flexible dosing (PRN) based on monthly monitoring and VA/OCT guided re-treatment criteria achieve functional and morphological changes close to those achieved after the three initiation doses. 26,27 However, regular monthly monitoring is required to achieve optimal outcomes.…”

Section: Parameters Used To Assess Response To Anti-vegf Therapiesmentioning

confidence: 99%

Defining response to anti-VEGF therapies in neovascular AMD

Amoaku

Chakravarthy

Gale

et al. 2015

Eye

270

227

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Section: Parameters Used To Assess Response To Anti-vegf Therapiesmentioning

confidence: 99%

Defining response to anti-VEGF therapies in neovascular AMD

Amoaku

Chakravarthy

Gale

et al. 2015

Eye

270

227

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“…Its natural course was once the main cause of irreversible vision loss in individuals aged Z50 years in industrialized countries. 1 Since the introduction of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment (first ranibizumab [2][3][4] and later aflibercept 5,6 ) as a new gold standard for the neovascular form of AMD (nAMD), the proportion of legally blind eyes has significantly decreased. 7 However, because monthly retreatment [2][3][4] places a heavy burden on the health-care system and on patients, 5 alternative treatment regimens have been explored.…”

Section: Introductionmentioning

confidence: 99%

Two-year outcome of an observe-and-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results

Gianniou

Dirani

Ferrini

et al. 2014

Eye

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Two-year outcome of an observeand-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results This article has been corrected since advance online publication and a corrigendum is also printed in this issue C Gianniou, A Dirani, W Ferrini, L Marchionno, D Decugis, A Deli, A Ambresin and I Mantel AbstractPurpose The purpose of this study was to report the 2-year outcome of an individually tailored 'observe-and-plan' treatment regimen for neovascular age-related macular degeneration (nAMD), and to investigate its clinical value in terms of functional outcome. This regimen aimed to reduce the clinical burden (visits) by employing individually fixed injection intervals, based on the predictability of an individual's need for retreatment. Methods This prospective case series included 104 patients (115 eyes) with nAMD. Following three loading doses of ranibizumab, the disease recurrence interval was determined in monthly observation visits. Retreatment was applied in a series of three injections with individually fixed intervals (2 weeks shorter than the recurrence interval), combined with periodic adjustment of the intervals. The allowed injection intervals in treatment plans ranged from 1 to 3 months. If there was no recurrence at 3 months, the patient could change to monitoring alone. Results Mean visual acuity (VA) improved by 8.7, 9.7, and 9.2 letters at months 3, 12, and 24, respectively. The mean number of injections was 7.8 and 5.8 during years 1 and 2, respectively, whereas the mean number of ophthalmic examinations was 4.0 and 2.9, respectively. The mean treatment interval (after the loading doses) was 2.0 months during year 1, and 2.2 months during year 2. Conclusion The observe-and-plan regimen significantly improved and maintained VA over the course of 2 years. This favourable functional outcome was achieved with fewer clinic visits compared with other regimens. Therefore, this observe-and-plan regimen has the potential to alleviate the clinical burden of nAMD treatment.

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“…Aflibercept (Eylea, Regeneron, Tarrytown, NY, USA) administered every 2 months following three monthly loading doses was noninferior to monthly ranibizumab (Lucentis, Genentech, South San Francisco, CA, USA) in treatment-naive nAMD 3 and monthly aflibercept is often effective in recalcitrant nAMD. [4][5][6] We examined nAMD patients transitioned to aflibercept who were previously treated with a 'treat-and-extend' protocol with either ranibizumab or bevacizumab (Avastin, Genentech, South San Francisco, CA, USA), and could not be extended exudation-free beyond an 8-week interval.…”

Section: Introductionmentioning

confidence: 99%

Transitioning to intravitreal aflibercept following a previous treat-and-extend dosing regimen in neovascular age-related macular degeneration: 24-month results

Homer

Grewal

Mirza

et al. 2015

Eye

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Purpose: To evaluate frequency of injections, visual and anatomical outcomes of neovascular age-related macular degeneration (nAMD) patients transitioned to intravitreal aflibercept after failure to extend treatment interval beyond 8 weeks with prior intravitreal bevacizumab or ranibizumab. Methods: Retrospective review of patients with nAMD switched to aflibercept following ≥ 6 prior intravitreal ranibizumab or bevacizumab injections at 4-8-week intervals. Three monthly aflibercept injections were given followed by a treat-and-extend dosing regimen. Results: Twenty-one eyes of 18 patients who had received a mean of 23.8 ± 18.8 (mean ± SD; range 6-62) prior ranibizumab or bevacizumab injections were included. Over a mean follow-up of 24 months after the transition, 9.2 ± 2.9 (range 4-21) aflibercept injections were required. Interval between aflibercept injections increased to 57.3 days (range 35-133 days), as compared with 37 ± 6.1 days (range 29-54 days) with the prior agents (P = 0.01). Mean best-corrected visual acuity was preserved (0.42 ± 0.31 vs 0.42 ± 0.23 logMAR; P = 0.2). Mean OCT central subfoveal thickness (292.1 ± 83.2 μm to 283.6 ± 78.6 μm; P = 0.4) and mean macular volume (7.9 ± 0.95 mm 3 to 7.67 ± 0.94 mm 3 ; P = 0.16) remained stable. Conclusion: Patients requiring treatment more frequently than every 8 weeks with ranibizumab and bevacizumab were transitioned to 48-week treatment interval with aflibercept while maintaining the anatomic and visual gains.

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Intravitreal Aflibercept (VEGF Trap-Eye) in Wet Age-related Macular Degeneration

Cited by 2,072 publications

References 20 publications

Defining response to anti-VEGF therapies in neovascular AMD

Defining response to anti-VEGF therapies in neovascular AMD

Two-year outcome of an observe-and-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results

Transitioning to intravitreal aflibercept following a previous treat-and-extend dosing regimen in neovascular age-related macular degeneration: 24-month results

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