Three-month outcome of intravitreal ziv-aflibercept in eyes with diabetic macular oedema

Abstract

Off-label use of intravitreal ziv-aflibercept improves visual acuity, without detectable ocular toxicity or systemic side effects in DME. It offers a less expensive alternative to the approved intravitreal aflibercept (Eylea), especially in the low/middle-income countries and in countries where Eylea is not available.

Long-term safety and efficacy of ziv-aflibercept in retinal diseases

“…In August 2012, US Food and Drug Administration approved ziv-aflibercept for the treatment of advanced colorectal carcinoma 9 12. Ziv-aflibercept is packaged at the same concentration of 1.25 mg/0.05 mL as 4 and 8 mL vials.…”

“…The dose of ziv-aflibercept used was 1.25 mg, which is 62.5% of the standard dose of 2 mg aflibercept used in VIEW, VIVID and VISTA protocols;9 12 however, in the VIEW trials, 0.5 and 2.0 mg produced quite comparable outcomes 6 9 12…”

“…Macular changes using spectral domain OCT were done monthly using 3D-2000 Topcon FA plus (Topcon, Tokyo, Japan) in Lebanon, Spectralis (Heidelberg Engineering GmbH, Heidelberg, Germany) in Egypt and Cirrus (Carl Zeiss Meditec, Dublin, California) in India. Central macular thickness (CMT) measurements (mean thickness in the central 1000 μm diameter area) were corrected for machine use according to established formulae 9 12. Intraocular pressure was measured using applanation tonometry.…”

Intravitreal injection of ziv-aflibercept in the treatment of choroidal and retinal vascular diseases

“…At 1 month after injection, mean CMT and the rate of CME had significantly declined compared to baseline, which is in accordance with previous case studies. 4 , 8 , 9 , 10 , 11 , 12 , 13 , 14 Avastin is currently the most cost-effective therapy for the management of choroidal and retinal vascular diseases. 4 In this study, although all ziv-aflibercept injections were prepared from a multi-dose vial, no case of intraocular infection was observed.…”

“…The latter studies also noted the relative safety of ziv-aflibercept after intravitreal administration for intraocular vascular disease. 4 , 8 , 13 , 16 However, complications may occur with frequent use and higher doses (up to 2 mg) of the drug.…”