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PAT survey shows steady increase in use of anti-VEGFs, healthy drive toward practice expansion

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VIENNA — The 2015 ASRS Preferences and Trends survey shows a steady increase in the use of anti-VEGFs, earlier switch of treatment for nonresponders and a growing consensus on treat-and-extend as best regimen when treating age-related macular degeneration. It also shows a healthy drive toward expansion of retina practices.

The survey received this year a record 896 responses from retina specialists, Thomas Stone, MD, said at the American Society of Retina Specialists meeting.

Thomas Stone

A growing number of surgeons approaching 80% of those responding consider switching to a new therapeutic agent in patients with age-related macular degeneration who do not respond adequately after fewer than six injections with the first agent. This tendency has grown markedly over the past 2 years. Eylea (aflibercept, Regeneron), outside cost considerations, is gaining increased popularity.

Gradually, treat-and-extend therapy has become the most prevalent treatment regimen, according to the survey.

“In 2010, [treat-and-extend] was below PRN, 3 years ago it was equal, and now it is used by more than 60% of the specialists,” Stone said.

In diabetic macular edema, decline of laser and marked advance of anti-VEGF as initial therapy was reported. From 25% in 2007 to more than 60% today, anti-VEGFs have become “a cornerstone of the initial treatment,” Stone said.

In the surgical section of the survey, the Alcon Constellation was shown to have widely become the preferred system for vitrectomy. Scleral buckling has continued to decline as treatment for retinal detachment, and use of topical antibiotics has declined with intravitreal injections.

“Socioeconomics have changed a lot,” Stone said. “In the past 2 years, double the number of responders said they are considering expanding to include more physicians or more locations.” — by Michela Cimberle

Disclosure: Stone reports no relevant financial disclosures.