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Researcher: Data inconclusive on as needed anti-VEGF therapy
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SAN FRANCISCO — Despite the adoption of non-monthly anti-VEGF dosing schedules by some retinal experts for treatment of exudative age-related macular degeneration, clinical trial evidence to date has not definitively proven that as-needed therapy is either superior or inferior to monthly dosing, according to a speaker here.
 Carl D. Regillo |
Since the first suggestion of a non-monthly dosing regimen in the PrONTO study, many retinal specialists have moved toward dosing individualization, with maintenance therapy provided based on changes seen on optical coherence tomography following an initial loading regimen, Carl D. Regillo, MD, FACS, said during a presentation at Retina Subspecialty Day preceding the American Academy of Ophthalmology meeting.
However, despite encouraging returns from the PrONTO study, longer follow up in the SUSTAIN and SAILOR trials — which included a 5 letter loss in visual acuity in treatment-naïve patients after an initial gain at 3 months and a loss of about 3 lines in treatment-experienced patients —- have yielded conflicting data.
"We really don't know with existing data whether any non-monthly therapy really stacks up or compares to pivotal studies," Dr. Regillo said. "What we do know is that there is a trend in existing data to indicate that better outcomes are achieved with more treatments and closer follow up."