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MIVI-TRUST outcomes strengthen support of ocriplasmin for vitreomacular adhesion
 Pravin U. Dugel |
BOSTON — Ocriplasmin may become the first pharmacologic option for patients with vitreomacular adhesion, according to two presentations here.
"This drug has a very broad spectrum of application in many of the clinical diseases that we treat today, and as such, this drug has the potential to change the way that we practice," Pravin U. Dugel, MD, said at the American Society of Retina Specialists meeting.
The phase 3 MIVI-TRUST (Microplasmin for intravitreous injection-traction release without surgical treatment) program included two randomized, placebo-controlled, double-masked multicenter studies assessing the use of single-dose 125-µg intravitreal ocriplasmin (ThromboGenics) for the treatment of vitreomacular adhesion.
At 28 days, vitreomacular adhesion resolved in 29.8% of the 464 eyes treated with ocriplasmin and 7.7% of the 188 eyes given placebo. Total posterior detachment occurred in 17% of treated eyes. Moreover, 25.5% gained two or more lines of visual acuity at 6 months.
"There is good evidence now to suggest that sequential injections, two or more injections [of ocriplasmin], will improve these results dramatically," Dr. Dugel said.
In a subanalysis presentation, Peter K. Kaiser, MD, OSN Retina/Vitreous Board Member and colleague of Dr. Dugel, added that vitreomacular adhesion is thought to cause at least 90% of macular holes. At 6 months, 40.6% of treated eyes achieved full-thickness macular hole closure, compared with only 17% of placebo eyes, Dr. Kaiser said.
- Disclosure: Dr. Dugel has no financial interest in the products discussed, nor is he a paid consultant for any companies mentioned. Dr. Kaiser receives travel support from ThromboGenics.