Ip recounts top findings from SCORE2
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WAILEA, Hawaii — Considering bevacizumab was found to be noninferior to aflibercept with respect to visual acuity in the SCORE2 trial, the incremental cost-effectiveness ratio is “unfavorable,” Michael S. Ip, MD, said at Retina 2021.
“The mathematics are fairly straightforward,” Ip said. “The 12-month differences are about $18,000 between bevacizumab and aflibercept groups, and the differences in quality of adjusted life-years ... are very small.”
The SCORE2 included 362 patients with macular edema associated with central or hemi-retinal vein occlusion randomized 1:1 to receive aflibercept or bevacizumab every 4 weeks through month 5. The primary outcome at 6 months was mean change from baseline in visual acuity score.
Also noteworthy in the SCORE2 was the finding that bevacizumab stored in small glass vials was “remarkably” stable, Ip said. For the trial, three batches of bevacizumab packaged in small glass vials were prepared at University of Pennsylvania. Study participants used 74% of the 2,362 vials available for use, with average time from re-packaging to intraocular injection being 7.1 months. At 21 months after re-packaging, two unused, expired vials were tested, and the expired product retained sterility, concentration, purity, appearance and 100% bioactivity compared with a fresh bevacizumab vial.
Such packaging may offer important advantages over prefilled plastic syringes, Ip said.
“I’ve gone to the compounding pharmacies. They’ve been very interested in these data, and I’ve advocated for providing bevacizumab in small glass vials and making them available to clinicians,” he said.
Oher remarkable findings of the SCORE2 were that less than fixed monthly dosing can achieve results similar to monthly dosing, initial visual response is the best predictor of future visual results, and 2-year results indicate the chronic nature of disease course in CRVO and HRVO, which points to the importance of continued monitoring to optimize visual acuity outcomes, according to Ip.
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Ip MS. Study of Comparative Treatment in Retinal Vein Occlusion 2 (SCORE2) top 5 findings. Presented at: Retina 2021; May 9-14, 2021; Wailea, Hawaii.
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