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New anti-VEGF shows good results in poor responders to previous anti-VEGF therapy
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COPENHAGEN, Denmark — Preliminary 8-month experience with aflibercept shows remarkable improvement in cases that responded poorly to previous continuous, extensive therapy with bevacizumab or ranibizumab, according to one specialist.
"In our clinic, we have an average volume of 7,000 intravitreal injections per year, and in the last 8 months, about 1,000 were aflibercept," Stephan Michels, MD, head of Medical Retina at Triemli Hospital in Zurich, Switzerland, said at the meeting of the European Society of Ophthalmology.
Stephan Michels
Eylea (aflibercept, Bayer / Regeneron) was approved in Switzerland in November 2012 for neovascular age-related macular degeneration. The Swiss treatment protocol recommends an induction phase with three monthly injections and an extension of treatment to every 8 weeks for 1 year and every 12 weeks thereafter. Decision criteria for re-treatment are visual acuity and morphologic results.
Michels presented a series of cases that, after many years of treatment and a high number of anti-VEGF injections alone or in combination with photodynamic therapy, showed a poor anatomical response, with extensive lesions and persistent subretinal fluid.
After one to three injections of aflibercept, complete reabsorption of subretinal fluid was observed. Unexpected effects were also obtained in pigment epithelial detachment and cystoid macular edema.
"There must be a different mechanism that we don’t see with other therapeutic strategies," Michels said, adding that unexpected effects continue to be seen.
Disclosure: Ocular Surgery News was unable to confirm whether Michels has any relevant financial disclosures.