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Exploring anti-VEGF therapy for wet AMD: What dosing strategy is best?
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KAANAPALI, Hawaii — With ongoing studies testing the safety and effectiveness of anti-VEGF therapies in treating wet AMD, the best dosing strategy is still in question, according to one presenter here.
"What we want to do is get the best vision, decrease the number of office visits and decrease the number of injections needed," Philip J. Rosenfeld, MD, PhD, said at the Retina 2011 meeting.
Overall, the goal is to get the macula dry and keep it dry, according to Dr. Rosenfeld, who said that three of the main strategies include monthly dosing, optical coherence tomography-guided dosing, and the "treat and extend" method. Each of these strategies has demonstrated utility, but phase 3 data is only available for monthly dosing, he said.
In the near future, study results for higher doses of anti-VEGF therapies and combination therapies are expected.
Additionally, higher-affinity therapies such as VEGF Trap-Eye (Regeneron) may play a large role in AMD treatment. While 2-week dosing of Avastin (bevacizumab, Genentech) or Lucentis (ranibizumab, Genentech) is better for maintaining the effect of anti-VEGF than 2-mg doses of ranibizumab administered monthly, according to Dr. Rosenfeld, 4-week dosing with VEGF Trap-Eye at the 2-mg level has already been shown to be theoretically superior to 2-week dosing.
The ultimate goal for the future would be the development of sustained-release therapies, Dr. Rosenfeld said.
- Disclosure: Dr. Rosenfeld has no relevant financial interest to disclose.
Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.