Fixed, frequent dosing optimal for wet AMD, but difficult to achieve
KOLOA, Hawaii — Despite fixed, frequent dosing being optimal for wet age-related macular degeneration management, ophthalmologists tend to favor non-fixed regimens like treat-and-extend in clinical practice, according to a presenter at Retina 2020.
Michael S. Ip, MD, believes this is because fixed, frequent dosing is a treatment burden. This dosing regimen is also difficult to apply and expensive, he said.
“We’ve searched long and hard to prove that non-fixed regimens may be effective,” Ip said.
Evidence from several published studies, both retrospective and prospective, have shown similar visual acuity outcomes with treat-and-extend compared with fixed, frequent dosing. However, in the real world, patients with wet AMD receive fewer anti-VEGF injections and experience suboptimal visual outcomes, he said.
“I would caution against saying treat-and-extend is equivalent to monthly dosing in all cases because it appears that we are undertreating these patients in the real world. ... An unmet need here is that we need to find more durable treatments to reduce this burden,” Ip said. – by Alaina Tedesco
Reference: Ip MS. Retinal fluid and treatment regimens in neovascular AMD: Does it make a difference? Presented at: Retina 2020; Jan. 19-24, 2020; Koloa, Hawaii.
Disclosure: Ip reports being a consultant for Alimera, Allergan, Amgen, Astellas, Boehringer Ingelheim, Genentech, Novartis, Omeros, Quark and Thrombogenics, and receiving research support from Biogen, Clearside, Genentech and Novartis.