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Underlying disease characteristics dictate anti-VEGF dosing interval

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BOSTON — Relegation to a greater than 12-week anti-VEGF dosing regimen was correlated with absence of leakage at 52 weeks in patients treated for neovascular age-related macular degeneration, according to a subgroup analysis of the VIEW 1 and 2 studies.

“The bottom line of this study is that there are some patients who are going to be able to be treated at 12 weeks dosing with aflibercept based on their underlying disease characteristics,” Anthony Joseph, MD, said at the American Society of Retina Specialists meeting.

The subgroup analysis was a second-year look at patients who had completed a year of anti-VEGF treatment with either Lucentis (ranibizumab, Genentech) or Eylea (aflibercept, Regeneron) in the VIEW studies. Treatments were continued through week 96 in either a less-than-every-12-week injection protocol or a 12-week-or-greater injection protocol based on visual acuity and various anatomic characteristics. Approximately 50% of patients treated with 2 mg aflibercept and 42.5% of patients treated with 0.5 mg ranibizumab in the first year of the VIEW studies were included in the 12-week-or greater protocol.

At 52 weeks, disease characteristics that influenced assignment to dosing group included best corrected visual acuity, central retinal thickness, area of choroidal neovascularization, total lesion area, type of choroidal neovascularization, presence or absence of fluid as seen on time domain OCT, and presence or absence of leakage as seen on fluorescein angiogram.

Retinal fluid and leakage on fluorescein angiogram were the factors most associated with dosing at less than every 12 weeks, and the results showed higher odds of patients with occult lesions requiring more frequent treatments than those with a classic component, according to Joseph. – by Patricia Nale, ELS

Reference:

Joseph A. Outcomes in patients with neovascular age-related macular degeneration based on dosing subgroups in the second year of the VIEW 1 and VIEW 2 studies. Presented at: American Society of Retina Specialists annual meeting; Aug. 11-15, 2017; Boston.

Disclosure: Joseph reports no relevant financial disclosures.