Two-year PANORAMA results affirm aflibercept efficacy for nonproliferative diabetic retinopathy
Two-year results of the PANORAMA study show consistently better results with intravitreal aflibercept injection vs. sham in moderately severe to severe nonproliferative diabetic retinopathy.
A higher rate of complications in the group that switched to as-needed dosing in the second year suggest that that regimen may lead to undertreatment in some cases.
The PANORAMA study involved 402 patients with nonproliferative diabetic retinopathy without diabetic macular edema. In the active treatment arms, patients were randomly assigned to receive, after completion of a loading phase, either intravitreal aflibercept 2 mg every 16 weeks for 2 years or every 8 weeks in the first year followed by as-needed dosing in the second year.
“A significantly higher proportion of patients in the group treated with either of the two aflibercept doses achieved the 2 step or greater improvement in Diabetic Retinopathy Severity Scale level,” Jennifer I. Lim, MD, principal investigator of the study, said at the virtual Association for Research in Vision and Ophthalmology meeting.
At week 52, 65% and 80% of 16-week and 8-week eyes, respectively, vs. 15% of sham eyes had a 2 step or greater improvement. At week 100, the same level was achieved by 62% and 50% of 16-week and 8-week eyes, respectively, vs. 13% of sham eyes.
The patients treated with intravitreal aflibercept had a 75% to 79% reduction in likelihood of developing a vision-threatening complication or DME as compared with patients in the sham arm.
“The less frequent dosing during year 2 in the PRN arm appeared to be associated with a higher rate of these complications,” Lim said. “Independent reading center review suggests that PRN decisions may have led to undertreatment in year 2.” – by Michela Cimberle
Lim JI. Intravitreal aflibercept injection for nonproliferative diabetic retinopathy: Year 2 results from the PANORAMA study. Association for Research in Vision and Ophthalmology annual meeting; May 6, 2020 (virtual meeting).
Disclosure: Lim reports she is a consultant to Genentech, Opthea, Santen and Novartis.