Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration

Justus G Garweg1,21Swiss Eye Institute, Rotkreuz, and Berner Augenklinik Am Lindenhofspital, Bern, Switzerland; 2Department of Ophthalmology, Inselspital, University of Bern, Bern, SwitzerlandPurpose: To review published evidence for a treatment interval extension to ≥12-weeks in neovascular...

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Autor principal:	Garweg JG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	neovascular age-related macular degeneration AMD Aflibercept intravitreal anti-VEGF injections treat-and-extend proactive treatment long-term outcome review Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/261e998235554db1a3605447656a0880
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spelling	oai:doaj.org-article:261e998235554db1a3605447656a08802021-12-02T05:50:28ZTwelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration1177-5483https://doaj.org/article/261e998235554db1a3605447656a08802019-07-01T00:00:00Zhttps://www.dovepress.com/twelve-week-dosing-with-aflibercept-in-the-treatment-of-neovascular-ag-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Justus G Garweg1,21Swiss Eye Institute, Rotkreuz, and Berner Augenklinik Am Lindenhofspital, Bern, Switzerland; 2Department of Ophthalmology, Inselspital, University of Bern, Bern, SwitzerlandPurpose: To review published evidence for a treatment interval extension to ≥12-weeks in neovascular macular degeneration treated with intravitreal Aflibercept.Methods: A systematic search was performed in the NCBI/PubMed database to identify pro- and retrospective studies retrieved by the key terms or and or AND AND and included all papers that used a treat-and-extend (T&E) protocol including a loading phase of 3 intravitreal anti-VEGF injections and a minimal follow-up of 2 years. Disease stability was defined as the absence of any intraocular and absence or stability of subretinal fluid and pigment-epithelial detachment.Results: Four studies were identified that reported information pertaining to disease stability or treatment extension beyond 12 weeks under intravitreal Aflibercept therapy including 1,102 eyes in total. Following a T&E protocol, a mean of 62.9% achieved disease stability and a 6.9 letter gain based on 11.9 injections over 24 months of Aflibercept treatment. As much as 43.0% of all eyes or 64.1% of the eyes with stable disease were maintained on ≥12-weekly injection intervals.Conclusions: A consequent treatment with a null tolerance for intraretinal fluid is prerequisite to induce stability and maintain visual gain after the loading phase. Using Aflibercept in a T&E protocol, disease stability and interval extension to ≥12 weeks were reported in 43% of the eyes by end of the second year with less injections, but similar results as under fix dosing. A lower treatment burden strongly argues for an individualized proactive treatment regimen.Keywords: neovascular age-related macular degeneration, AMD, Aflibercept, intravitreal anti-VEGF injections, treat-and-extend, proactive treatment, long-term outcome, reviewGarweg JGDove Medical Pressarticleneovascular age-related macular degenerationAMDAfliberceptintravitreal anti-VEGF injectionstreat-and-extendproactive treatmentlong-term outcomereviewOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1289-1295 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	neovascular age-related macular degeneration AMD Aflibercept intravitreal anti-VEGF injections treat-and-extend proactive treatment long-term outcome review Ophthalmology RE1-994
spellingShingle	neovascular age-related macular degeneration AMD Aflibercept intravitreal anti-VEGF injections treat-and-extend proactive treatment long-term outcome review Ophthalmology RE1-994 Garweg JG Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration
description	Justus G Garweg1,21Swiss Eye Institute, Rotkreuz, and Berner Augenklinik Am Lindenhofspital, Bern, Switzerland; 2Department of Ophthalmology, Inselspital, University of Bern, Bern, SwitzerlandPurpose: To review published evidence for a treatment interval extension to ≥12-weeks in neovascular macular degeneration treated with intravitreal Aflibercept.Methods: A systematic search was performed in the NCBI/PubMed database to identify pro- and retrospective studies retrieved by the key terms or and or AND AND and included all papers that used a treat-and-extend (T&E) protocol including a loading phase of 3 intravitreal anti-VEGF injections and a minimal follow-up of 2 years. Disease stability was defined as the absence of any intraocular and absence or stability of subretinal fluid and pigment-epithelial detachment.Results: Four studies were identified that reported information pertaining to disease stability or treatment extension beyond 12 weeks under intravitreal Aflibercept therapy including 1,102 eyes in total. Following a T&E protocol, a mean of 62.9% achieved disease stability and a 6.9 letter gain based on 11.9 injections over 24 months of Aflibercept treatment. As much as 43.0% of all eyes or 64.1% of the eyes with stable disease were maintained on ≥12-weekly injection intervals.Conclusions: A consequent treatment with a null tolerance for intraretinal fluid is prerequisite to induce stability and maintain visual gain after the loading phase. Using Aflibercept in a T&E protocol, disease stability and interval extension to ≥12 weeks were reported in 43% of the eyes by end of the second year with less injections, but similar results as under fix dosing. A lower treatment burden strongly argues for an individualized proactive treatment regimen.Keywords: neovascular age-related macular degeneration, AMD, Aflibercept, intravitreal anti-VEGF injections, treat-and-extend, proactive treatment, long-term outcome, review
format	article
author	Garweg JG
author_facet	Garweg JG
author_sort	Garweg JG
title	Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration
title_short	Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration
title_full	Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration
title_fullStr	Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration
title_full_unstemmed	Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration
title_sort	twelve-week dosing with aflibercept in the treatment of neovascular age-related macular degeneration
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/261e998235554db1a3605447656a0880
work_keys_str_mv	AT garwegjg twelveweekdosingwithafliberceptinthetreatmentofneovascularagerelatedmaculardegeneration
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Twelve-week dosing with Aflibercept in the treatment of neovascular age-related macular degeneration

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