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Specialist speaks in favor of anti-VEGF with bimonthly regimen
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LISBON, Portugal — Aflibercept, a designed molecule that can meet all expectations from the start of treatment, is the latest promising option in the treatment of age-related macular degeneration, according to one specialist.
“It’s a fusion of the most high-affinity binding domains of the receptors and should provide higher affinity than ranibizumab (Lucentis, Genentech/Novartis) and bevacizumab (Avastin, Genentech/Roche) and even higher affinity than the VEGF binding to native receptors. Better than nature — that’s quite something,” Ursula Schmidt-Erfurth, MD, said at the Controversies in Ophthalmology meeting.
Ursula Schmidt-Erfurth
It also provides 1:1 binding, not allowing accumulation that leads to inflammation, she said.
Schmidt-Erfurth said that the literature has shown that the biological activity of Eylea (aflibercept, Regeneron/Bayer) is “even longer than expected,” leading to efficient treatment.
She talked about the real-life scenario of AMD treatment in busy hospital units as a “daily struggle for survival.” The bimonthly 2Q8 regimen (dosing every 2 months after three initial monthly doses) suggested by the VIEW studies might be the “exit formula” that allows maintaining the benefits of monthly treatment by reducing the burden by 50% and being 100% more efficient.
“With only seven injections in the first year, you can be just as good as with the 12 injections and even better in practical terms,” Schmidt-Erfurth said.
“PRN is very attractive because treatment as needed is a medical paradigm. However, the burden of monthly monitoring with 12 OCTs remains,” she said.
Disclosure: Schmidt-Erfurth is a consultant to Bayer, Alcon and Novartis.