High-dose aflibercept maintains visual acuity in wet AMD
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DENVER — High-dose aflibercept maintained visual acuity in patients with neovascular age-related macular degeneration at 48 months, according to a study presented at the Association for Research in Vision and Ophthalmology meeting.
Nicole K. Scripsema, MD, told Healio/OSN that she and colleagues wanted to take a closer look at their practice protocol for how patients respond to AMD treatment.
“For patients with [AMD], we’re very concerned about cost efficiency and cost of health care,” she said. “Everyone who comes in is started on Avastin (bevacizumab, Genentech). Everyone got the same number of Avastin before determining that they were a nonresponder and switched over to Eylea. ... There was a group of people who weren’t responding to Eylea, so we increased the dose.”
The retrospective review included 200 eyes of 177 patients with neovascular AMD treated with standard-dose Eylea (aflibercept, Regeneron) (2 mg/0.05 mL) and high-dose aflibercept (3 mg/0.075 mL). Visual acuity, central retinal thickness (CRT) and qualitative OCT from baseline to 48 months were compared.
Mean visual acuity was stable over 48 months. The high-dose group had thicker mean CRT at baseline and required more injections. However, both groups showed improvement in CRT over 48 months.
Out of 100 eyes that had a suboptimal response to monthly bevacizumab and monthly aflibercept, 95% achieved a dry macula with monthly high-dose aflibercept.
“We’re finding that patients who don’t respond to Eylea are having excellent outcomes by just increasing the dose,” Scripsema said. “Outcomes are good, and patients are happy.”
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Scripsema NK, et al. Aflibercept and high-dose aflibercept: Real-world outcomes at 48 months. Presented at: Association for Research in Vision and Ophthalmology meeting; May 1-4, 2022; Denver.
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