Reply to: ‘Comment on: ‘One-year real-world outcomes in patients receiving fixed-dosing aflibercept for neovascular age-related macular degeneration’

Almuhtaseb, Hussein; Lotery, Andrew

doi:10.1038/eye.2017.212

Cited by 1 publication

(3 citation statements)

References 9 publications

(6 reference statements)

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“…This difference was also reflected over 2 years of the ARIES study, with patients in the late-start T&E arm switching to a T&E regimen in the second year 18 . Almuhtaseb et al 32 reported comparable injection numbers over 12 months with ranibizumab T&E and aflibercept bimonthly dosing in an observational study.…”

Section: Resultsmentioning

confidence: 96%

“…The ARIES trial comparing early-start T&E (T&E starting in Year 1) and late-start T&E (bimonthly dosing in Year 1, followed by T&E in Year 2) reported a comparable mean change in BCVA in both groups from randomization at Week 16 to Week 52 (+0.9 vs +1.1 letters, respectively) 31 . An observational study by Almuhtaseb et al 32 assessed visual outcomes with ranibizumab T&E and aflibercept bimonthly dosing, reporting comparable BCVA gains from baseline to Month 12 (+8.3 vs +7.5 letters, respectively; P = 0.1550).…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen of 22 studies assessing a T&E regimen (excluding meta-analyses) employed a traditional T&E regimen requiring complete resolution of both intraretinal fluid (IRF) and subretinal fluid (SRF) on optical coherence tomography (OCT) as a definition for “inactive disease” to allow extension of the treatment interval. These studies were the CANTREAT, 26,30 In-Eye, 33 LUCAS, 44,49 RIVAL, 45,50 TREND 27 trials, and many observational studies 24,32,37,39,42,43,46,51 . However, FLUID, 23 ALTAIR, 20 and ARIES 18,31 and 2 observational studies, 41,47 have indicated the potential for vision gains with a T&E regimen without the need to aim for complete fluid resolution.…”

Section: Resultsmentioning

confidence: 99%

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Treat-and-Extend Regimens for the Management of Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy: Consensus and Recommendations From the Asia-Pacific Vitreo-retina Society

Chaikitmongkol

Sagong

Lai

et al. 2021

Asia-Pacific Journal of Ophthalmology

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Purpose: Review and provide consensus recommendations on use of treat-and-extend (T&E) regimens for neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) management with relevance for clinicians in the Asia-Pacific region. Methods: A systematic search of MEDLINE, EMBASE, and Cochrane databases, and abstract databases of the Asia-Pacific Vitreo-retina Society, European Society of Retina Specialists, American Academy of Ophthalmology, and Controversies in Ophthalmology: Asia-Australia congresses, was conducted to assess evidence for T&E regimens in nAMD. Only studies with ≥100 study eyes were included. An expert panel reviewed the results and key factors potentially influencing the use of T&E regimens in nAMD and PCV, and subsequently formed consensus recommendations for their application in the Asia-Pacific region. Results: Twenty-seven studies were included. Studies demonstrated that T&E regimens with aflibercept, ranibizumab, or bevacizumab in nAMD, and with aflibercept in PCV, were efficacious and safe. The recommendation for T&E is, after ≥3 consecutive monthly loading doses, treatment intervals can be extended by 2 to 4 weeks up to 12 to 16 weeks. When disease activity recurs, the recommendation is to reinject and shorten intervals by 2 to 4 weeks until fluid resolution, after which treatment intervals can again be extended. Intraretinal fluid should be treated until resolved; however, persistent minimal subretinal fluid after consecutive treatments may be tolerated with treatment intervals maintained or extended if the clinical condition is stable. Conclusions: T&E regimens are efficacious and safe for nAMD and PCV, can reduce the number of visits, and minimize the overall burden for clinicians and patients.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%