Treat-and-extend regimen reduces injection burden in macular edema secondary to CRVO
VIENNA — Intravitreal aflibercept injection with an individualized treat-and-extend schedule is a positive approach to macular edema secondary to central retinal vein occlusion, according to a study presented at the Euretina meeting.
“Fixed and PRN regimens lead to significant discomfort and cost, while T&E has a more flexible schedule for follow-up visits, depending on the individual evolution of the disease. It is a proactive treatment regimen that allows early re-treatment of the lesion before reactivation and eventually results in fewer injections and fewer visits,” José García-Arumi, MD, PhD, said.
The NEUTON study included 24 patients with macular edema secondary to CRVO treated at 11 centers in Spain and followed for 1 year. The protocol consisted of a loading dose of three Eylea (aflibercept, Bayer/Regeneron) injections followed by a treat-and-extend protocol.
An improvement of 15 or more letters was obtained in 37% of patients at 12 weeks and in 50% of patients at 1 year. Mean retinal thickness was reduced by 272 µm at week 12 and 296 µm at 1 year; 79% of patients were free of macular edema at week 12 and 1 year. Significant improvement in best corrected visual acuity was observed during the loading phase, followed by a peak at the end of the treat-and-extend regimen. These results were consistent with those of the GALILEO and COPERNICUS confirmatory studies using as-needed regimens.
“One of the most significant data was the reduction in number of injections, 8.3 as compared with the 11.8 and 9.9 injections, respectively, performed during the first year of GALILEO and COPERNICUS. The mean interval between injections during the T&E phase was 7 weeks,” García-Arumi said.
No serious ocular or systemic events were reported.
“This treatment schedule allows for significant VA gain and reduction of the edema with fewer injections and consequent reduction of the patients’ burden as compared with PRN,” García-Arumi said. – by Michela Cimberle
García-Arumi J, et al. A phase IV study to assess efficacy and safety of a treat-and-extend regimen of aflibercept for treatment of macular edema secondary to central retinal vein occlusion in naïve patients. NEUTON study. Presented at: Euretina; Sept. 20, 2018; Vienna.
Disclosure: García-Arumi reports he is a consultant for Novartis, Bayer and Alcon.