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July 21, 2020
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Increasing dose of aflibercept may be beneficial in refractory AMD

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Patients with refractory neovascular age-related macular degeneration were more likely to experience greater decreases in central foveal thickness when treated with higher doses of aflibercept.

“More specifically, patients are more likely to experience a decrease in central foveal thickness, and thus decreased subretinal fluid, but may not achieve such significant subretinal fluid resolution that would lead to interval extension,” Sidney D. Smith said at the virtual Association for Research in Vision and Ophthalmology meeting.

Infographic explaining three results of .1mL injections

Smith and colleagues evaluated the effect of increasing the dose of intravitreal Eylea (aflibercept, Regeneron) from a standard dose of 0.05 mL to a high dose of 0.07 mL and subsequently to a higher dose of 0.1 mL in participants already receiving high-frequency treatment.

Upon escalation from 0.05 mL to 0.07 mL, 7% of the 25 participants saw no change in their treatment interval, the treatment interval was extended in 10%, and the treatment interval decreased in 83%. When escalated to the 0.1 mL dose, 16% saw no change, the treatment interval was extended in 36%, and the treatment interval decreased in 48%.

When escalated to 0.07 mL, 24% of participants experienced increased central foveal thickness, 32% experienced decreased central foveal thickness, and 44% experienced no significant change. When increased to 0.1 mL, 12% of participants experienced no significant change, 36% experienced increased central foveal thickness, and 52% experienced decreased central foveal thickness.

“The data suggests that in patients with refractory neovascular age-related macular degeneration, escalating the dose from standard dose to a higher dose can lead to improved outcomes in some patients,” she said.