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Ziv-aflibercept may be safe, less expensive alternative to other anti-VEGF treatments

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Kapil G. Kapoor

SAN FRANCISCO — Ziv-aflibercept could be an effective and cost-reducing alternative to traditional anti-VEGF therapies in the treatment of neovascular age-related macular degeneration, according to a speaker here.

“The aflibercept molecule and the ziv-aflibercept molecule are the exact same molecule. They bind to the same isoforms of VEGF, they have the exact same molecular weight, and they differ only in the osmolarity of their solution,” Kapil G. Kapoor, MD, said at the American Academy of Ophthalmology annual meeting.

A prospective, randomized, case-control study enrolled 56 wet AMD subjects who had previously received anti-VEGF treatment. Those in the treatment group received 1.25 mg/0.5 mL ziv-aflibercept, and those in the control group continued to receive their current anti-VEGF regimen.

Patients who were treated with ziv-aflibercept had no statistically significant difference in baseline and endpoint vision and no changes in functions or anatomy compared with those treated with aflibercept, ranibizumab or bevacizumab, according to Kapoor.

“Ziv-aflibercept is a safe and effective alternative to currently available anti-VEGF medication in treating neovascular AMD. It is noninferior in respect to function, anatomy and complication rates,” he said.

The major difference in ziv-aflibercept is the cost. If everyone switched from aflibercept to ziv-aflibercept on Jan. 1, 2020, there could be a $3 billion CMS savings in just 2 years.

“All docs that are using intravitreal injections are huge gatekeepers of CMS dollars, and I think it speaks to our patriotic duty to be gatekeepers of these responsibly,” Kapoor said. “If we don’t start making responsible decisions for them, others are going to start making those decisions for us.” – by Rebecca L. Forand

Reference:

Kapoor K. 15-month results of the ZEBRA study: ziv-aflibercept efficacy in better regulating AMD. Presented at: American Academy of Ophthalmology annual meeting; Oct. 11-15, 2019; San Francisco.

Disclosure : Kapoor reports no relevant financial disclosures.