Intravitreal Aflibercept Injection for Neovascular Age-related Macular Degeneration

Schmidt‐Erfurth, Ursula; Kaiser, Peter K.; Korobelnik, J.-F.; Brown, David M.; Chong, Victor; Nguyen, Quan Dong; Ho, Allen C.; Ogura, Yuichiro; Simader, Christian; Jaffe, Glenn J.; Slakter, Jason S.; Yancopouloš, George D.; Stahl, Neil; Vitti, Robert; Berliner, Alyson J.; Soo, Yuhwen; Anderesi, Majid; Sowade, Olaf; Zeitz, Oliver; Norenberg, Christiane; Sandbrink, Rupert; Heier, Jeffrey S.

doi:10.1016/j.ophtha.2013.08.011

Cited by 727 publications

(676 citation statements)

References 17 publications

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“…Mean VA gain of eight ETDRS letters in a real-world setting was comparable to VIEW 1 and VIEW 2 Trials' of 8.4 letters in the integrated analysis of the VIEW 1 and VIEW 2 studies (7.9 letters in VIEW 1 and 8.9 letters in VIEW 2 at end of year 1). 4 The VA gain after loading (represented by a mean BCVA of 0.48 LogMar) was maintained throughout the 1-year treatment plan (mean BCVA of 0.50 at M11).…”

Section: Resultsmentioning

confidence: 91%

“…Aflibercept has gained FDA approval for the treatment of neovascular AMD in 2011 based on a comparison with ranibizumab in the VIEW 1 and VIEW 2 trials. 3,4 Aflibercept administered at 8-weekly intervals over the first year, following a loading dose of 3 monthly injections, delivered the same VA results as administering monthly ranibizumab. 3 An 8-weekly fixed regimen requires fewer monitoring visits and helps solve capacity issues compared with a Pro Re Nata or treat-and-extend regimen.…”

Section: Introductionmentioning

confidence: 99%

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One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration

Almuhtaseb

Kanavati

Rufai

et al. 2017

Eye

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Purpose To investigate 1-year visual and anatomic outcomes of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) given at a fixed 8-weekly interval. Methods Retrospective, single-practice data analysis from an electronic medical record system of 255 eyes (223 patients) with treatment-naïve nAMD receiving 8-weekly aflibercept.Results Mean logarithm of the minimum angle of resolution best-corrected visual acuity (BCVA) improved from 0.66 at baseline to 0.50 at month 11 (Po0.0001). Mean central retinal thickness (CRT) decreased from 311μm at baseline to 211μm at month 11 (Po0.0001). Our mean VA gain of eight ETDRS letters was comparable to the VIEW 1 and VIEW 2 Trials' results at the end of year 1. After loading at month 5, mean BCVA was 0.48 (Po0.0001), and mean CRT was 235 μm. At month 5, 143 eyes (56%) were inactive defined by the absence of macular haemorrhage and intraretinal fluid (IRF) and subretinal fluid (SRF) on optical coherence tomography, and 112 eyes (44%) remained active. At month 11, 136 eyes (53%) were inactive, and 119 eyes (47%) remained active. At month 11, 77% of inactive eyes after loading remained inactive, and 77% of the active eyes after loading remained active. At month 11, mean BCVA of the inactive group was 0.51, and mean BCVA of the active group was 0.48 (P = 0.54). Conclusions Aflibercept administered by fixed dosing over 1 year improved VA and macular morphology in treatment-naïve eyes. Active lesions at month 11 do not have worse VA outcomes compared with inactive lesions. The macular status after loading is a reliable indicator of disease activity at the end of year 1.

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Section: Resultsmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration

Almuhtaseb

Kanavati

Rufai

et al. 2017

Eye

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“…1 Since the introduction of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment (first ranibizumab [2][3][4] and later aflibercept 5,6 ) as a new gold standard for the neovascular form of AMD (nAMD), the proportion of legally blind eyes has significantly decreased. 7 However, because monthly retreatment [2][3][4] places a heavy burden on the health-care system and on patients, 5 alternative treatment regimens have been explored. Simply reducing the intravitreal injections to a fixed retreatment every 3 months was significantly inferior to monthly injections and resulted in the loss of initial visual acuity (VA) improvement.…”

Section: Introductionmentioning

confidence: 99%

Two-year outcome of an observe-and-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results

Gianniou

Dirani

Ferrini

et al. 2014

Eye

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Two-year outcome of an observeand-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results This article has been corrected since advance online publication and a corrigendum is also printed in this issue C Gianniou, A Dirani, W Ferrini, L Marchionno, D Decugis, A Deli, A Ambresin and I Mantel AbstractPurpose The purpose of this study was to report the 2-year outcome of an individually tailored 'observe-and-plan' treatment regimen for neovascular age-related macular degeneration (nAMD), and to investigate its clinical value in terms of functional outcome. This regimen aimed to reduce the clinical burden (visits) by employing individually fixed injection intervals, based on the predictability of an individual's need for retreatment. Methods This prospective case series included 104 patients (115 eyes) with nAMD. Following three loading doses of ranibizumab, the disease recurrence interval was determined in monthly observation visits. Retreatment was applied in a series of three injections with individually fixed intervals (2 weeks shorter than the recurrence interval), combined with periodic adjustment of the intervals. The allowed injection intervals in treatment plans ranged from 1 to 3 months. If there was no recurrence at 3 months, the patient could change to monitoring alone. Results Mean visual acuity (VA) improved by 8.7, 9.7, and 9.2 letters at months 3, 12, and 24, respectively. The mean number of injections was 7.8 and 5.8 during years 1 and 2, respectively, whereas the mean number of ophthalmic examinations was 4.0 and 2.9, respectively. The mean treatment interval (after the loading doses) was 2.0 months during year 1, and 2.2 months during year 2. Conclusion The observe-and-plan regimen significantly improved and maintained VA over the course of 2 years. This favourable functional outcome was achieved with fewer clinic visits compared with other regimens. Therefore, this observe-and-plan regimen has the potential to alleviate the clinical burden of nAMD treatment.

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“…However, the remaining patients did not achieve positive results, leading to the clinical outcome of permanent vision loss. Recently published studies have discussed the effectiveness of intravitreal aflibercept in cases involving insufficient responses to ranibizumab treatment and the development of recurrence and tolerance in subsequent months (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) . Additional studies have shown that a change of intravitreal agents might be effective in patients with neovascular…”

Section: Introductionmentioning

confidence: 99%

Efficacy of aflibercept on exudative age-related macular degeneration in patients exhibiting complete ranibizumab resistance and tachyphylaxis

Gökçe¹,

Durukan²,

Koylu³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Purpose: The present study compared the efficacy of aflibercept for neovascular age-related macular degeneration (NV-AMD) in patients with complete ranibizumab resistance and tachyphylaxis. Methods: Forty-four eyes of 38 neovascular age-related macular degeneration patients were evaluated. Eyes were divided into a complete resistance group (n=23 eyes) and tachyphylaxis group (n=21 eyes). Results: After three injections, eight (38.1%) patients in the tachyphylaxis group and nine (39.1%) in the complete resistance group presented with macular dryness. After the first injection of aflibercept, the mean visual acuity improved significantly in the tachyphylaxis group (p=0.018) but remained unchanged in the complete resistance group (p=0.37). There was a non-significant trend towards improved mean visual acuity in both groups after the second and third injections relative to the acuity at the final visit for ranibizumab treatment. In the tachyphylaxis group, the presence of subfoveal pigmented epithelium detachment (PED) decreased significantly after intravitreal aflibercept treatment. Conclusions: Although treatment with aflibercept yielded generally positive anatomical results in both groups, no significant increase in visual acuity was achieved. Keywords

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Intravitreal Aflibercept Injection for Neovascular Age-related Macular Degeneration

Cited by 727 publications

References 17 publications

One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration

One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration

Two-year outcome of an observe-and-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results

Efficacy of aflibercept on exudative age-related macular degeneration in patients exhibiting complete ranibizumab resistance and tachyphylaxis

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