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Anti-VEGF injection frequency a key factor in visual outcomes
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SAN FRANCISCO — Frequency of anti-VEGF injections has a significant impact on visual outcomes in the treatment of neovascular age-related macular degeneration, according to a poster presented at the American Society of Retina Specialists annual meeting.
“There is a ceiling effect, highlighting a limitation of anti-VEGF therapy for nAMD,” lead author Rehan Hussain, MD, and colleagues wrote. “Fewer than nine injections in the first year is associated with worse visual outcomes, highlighting treatment burden as a limitation of anti-VEGF therapy for nAMD.”
Hussain and colleagues conducted a meta-analysis of studies using the treat-and-extend regimen for neovascular AMD. Results were compared with those of phase 3 trials using monthly treatment (ANCHOR, MARINA, CATT, IVAN, VIEW), quarterly treatment (PIER and EXCITE) and as-needed (PRN) treatment (PRONTO, SAILOR, SUSTAIN, HARBOR, CATT, IVAN).
When pooling 21 treatment arms, results showed a linear correlation between number of injections of ranibizumab (Lucentis, Genentech) and bevacizumab (Avastin, Genentech) and number of letters gained at 12 months.
When studies were sorted by number of injections in the first year, mean gain in letters “did not increase beyond a mean of nine or more injections in the first 12 months, suggesting visual outcome generally plateaus after approximately nine injections in the first 12 months of treatment,” the authors said.
Fewer than nine injections in the first year was associated with worse visual outcomes.
“Analysis of studies with fewer than nine injections in 12 months revealed greater linear correlation (r = 1.61, R2 = 0.47), suggesting that 47% of the variability in letters gained in the first 12 months is related to injection frequency,” the researchers wrote.– by Matt Hasson
Reference:
Hussain R, et al. A meta-analysis of anti-VEGF treatment regimens for neovascular AMD: One year results are driven in part by the injection frequency (poster). Presented at: American Society of Retina Specialists 34th Annual Meeting, Aug. 9-14, 2016; San Francisco, Calif.
Disclosure: Hussain reports no relevant financial disclosures.