Treat-and-Extend Therapy With Aflibercept Offers Long-Term Improvement in Macular Degeneration: Presented at ARVO

By Danny Kucharsky

VANCOUVER -- May 3, 2019 -- Long-term treat-and-extend therapy with aflibercept leads to significant visual and anatomical improvements in patients with neovascular age-related macular degeneration (AMD), according to results of a retrospective study presented at the 2019 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO).

Shigeo Yoshida, MD, Kurume University, Kurume, Fukuoka, Japan and colleagues examined 39 eyes of 39 patients with treatment-naïve AMD with a treat-and-extend regimen of intravitreal aflibercept. Investigators assessed best-corrected visual acuity, central macular thickness, number of injections and treatment intervals for 4 years. Thirty-five (87.5%) and 31 patients (77.5%) completed year 1 and year 2, respectively.

The investigators reported a mean logMAR best-corrected visual acuity of 0.42, 0.29, 0.34, 0.36, and 0.35 at 0, 1, 2, 3, and 4 years, respectively.

Best-corrected visual acuity significantly improved after the loading phase and was maintained in the maintenance phase.

Central macular thickness significantly reduced after the loading phase, and those results were maintained throughout the follow-up period.

The mean number of injections was 7.9, 6.0, 5.5, and 5.4 during the first, second, third, and fourth year, respectively. Twelve-week or longer treatment intervals were used in 46%, 46%, 44%, and 45% of patients during the first-, second-, third-, and fourth-year time points, respectively.

Dr. Yoshida said that the study’s retrospective design may help to alleviate the potential investigator bias that can sometimes be present in open-label studies.

He concluded that treat-and-extend therapy with aflibercept over 4 years is a rational strategy with satisfactory outcomes.

According to the American Academy of Ophthalmology, a treat-and-extend regimen in nAMD follows a course in which the patient’s retina is first cleared of macular fluid and retinal haemorrhages with a series of monthly drug injections. The physician then begins extending the interval between treatments, 2 weeks at a time, as long as the retina remains dry and stable.

[Presentation title: Four-year Results of a Treat-and-Extend Therapy Using Aflibercept for Neovascular Age-related Macular Degeneration. Abstract 1156 - A0170]

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