Patients with active exudative age-related macular degeneration (AMD) are being treated with various treatment regimen, which may include intravitreal ranibizumab (lucentis), bevacizumab (avastin), aflibercept (eylea), etc. Some of these patients do not show benefit from these treatments, including repeat injections in many cases.
Switching therapies in neovascular AMD may offer an advantage for some patients. This study, as published by Rishi P Singh, Andrew P Schachat, Peter K Kaiser and their colleagues at Cole Eye Institute in the journal Clinical Ophthalmology, evaluated the efficacy of intravitreal aflibercept injection in subjects previously treated with ranibizumab and/or bevacizumab.
The study was a single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study). They publish their 12-month analysis in the journal .
In this study, 26 subjects were given monthly 2 mg of intravitreal aflibercept for 3 months, followed by 2 mg once in every 2 months for up to 12 months. The mean absolute change from baseline in central subfield thickness (CST) measured by optical coherence tomography and the mean change from baseline in best-corrected visual acuity (BCVA) early treatment in diabetic retinopathy study (ETDRS) letter score were obtained. Additionally, the percentage of subjects who gained or lost ≥15 letters of vision and the percentage of subjects who are 20/40 or better or 20/200 or worse were evaluated.
There was a mean decrease in CST of -50.3 µm (p<0.001) and a mean increase in ETDRS BCVA of +9.2 letters (p<0.001). Twenty-seven percent of subjects experienced a ≥15-letter improvement in visual acuity, and no subject lost ≥3 lines of vision from baseline. Fifty percent of subjects were 20/40 or better, and 11.5% of subjects were 20/200 or worse at month 12.
The authors conclude that fixed intravitreal aflibercept dosing regimen for 12 months demonstrates improved anatomic and vision endpoints from baseline in subjects with active exudative AMD.