One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration.

Abstract

PurposeTo investigate 1-year visual and anatomic outcomes of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) given at a fixed 8-weekly interval.MethodsRetrospective, single-practice data analysis from an electronic medical record system of 255 eyes (223 patients) with treatment-naïve nAMD receiving 8-weekly aflibercept.ResultsMean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) improved from 0.66 at baseline to 0.50 at month 11 (P<0.0001). Mean central retinal thickness (CRT) decreased from 311 μm at baseline to 211 μm at month 11 (P<0.0001). Our mean VA gain of eight ETDRS letters was comparable to the VIEW 1 and VIEW 2 Trials' results at the end of year 1. After loading at month 5, mean BCVA was 0.48 (P<0.0001), and mean CRT was 235 μm. At month 5, 143 eyes (56%) were inactive defined by the absence of macular haemorrhage and intraretinal fluid (IRF) and subretinal fluid (SRF) on optical coherence tomography, and 112 eyes (44%) remained active. At month 11, 136 eyes (53%) were inactive, and 119 eyes (47%) remained active. At month 11, 77% of inactive eyes after loading remained inactive, and 77% of the active eyes after loading remained active. At month 11, mean BCVA of the inactive group was 0.51, and mean BCVA of the active group was 0.48 (P=0.54).ConclusionsAflibercept administered by fixed dosing over 1 year improved VA and macular morphology in treatment-naïve eyes. Active lesions at month 11 do not have worse VA outcomes compared with inactive lesions. The macular status after loading is a reliable indicator of disease activity at the end of year 1.

• Authors: H Almuhtaseb, S Kanavati, S R Rufai, A J Lotery
• Journal: Eye (London, England) (Eye (Lond)) Vol. 31 Issue 6 Pg. 878-883 (Jun 2017) ISSN: 1476-5454 [Electronic] England
• PMID: 28186507 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Recombinant Fusion Proteins
• aflibercept
• Receptors, Vascular Endothelial Growth Factor

Topics

• Aged, 80 and over
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fundus Oculi
• Humans
• Intravitreal Injections
• Male
• Receptors, Vascular Endothelial Growth Factor (administration & dosage, antagonists & inhibitors)
• Recombinant Fusion Proteins (administration & dosage)
• Retina (pathology)
• Retrospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Visual Acuity
• Wet Macular Degeneration (diagnosis, drug therapy, physiopathology)