Source:

Brown DM, et al. JAMA Ophthalmol. 2021.doi:10.1001/jamaophthalmol.2021.2809

Disclosures: Brown reports receiving grants from Regeneron Pharmaceuticals during the conduct of the study and grants from Adverum Biotechnologies, Genentech, Heidelberg Pharma, Kodiak Sciences, Novartis, Regeneron Pharmaceuticals, and Regenxbio. Brown also reports personal fees from Adverum Biotechnologies, Allergan, Chengdu Kanghong Biotech, Clearside Biomedical, Genentech, Kodiak Sciences, Novartis, Ohr Pharmaceutical, Regeneron Pharmaceuticals, Regenxbio, Samsung Bioepis, and Santen Pharmaceutical and consultancy work for Bayer, BioTime, Kodiak Sciences, Optos, and Senju Pharmaceutical outside the submitted work.
September 05, 2021
1 min read
Save

PANORAMA trial results show efficacy of proactive anti-VEGF treatment for NPDR

Source:

Brown DM, et al. JAMA Ophthalmol. 2021.doi:10.1001/jamaophthalmol.2021.2809

Disclosures: Brown reports receiving grants from Regeneron Pharmaceuticals during the conduct of the study and grants from Adverum Biotechnologies, Genentech, Heidelberg Pharma, Kodiak Sciences, Novartis, Regeneron Pharmaceuticals, and Regenxbio. Brown also reports personal fees from Adverum Biotechnologies, Allergan, Chengdu Kanghong Biotech, Clearside Biomedical, Genentech, Kodiak Sciences, Novartis, Ohr Pharmaceutical, Regeneron Pharmaceuticals, Regenxbio, Samsung Bioepis, and Santen Pharmaceutical and consultancy work for Bayer, BioTime, Kodiak Sciences, Optos, and Senju Pharmaceutical outside the submitted work.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

New results suggest that proactive treatment of severe nonproliferative diabetic retinopathy with aflibercept injections may lead to improvement of disease severity.

Study results from the PANORAMA trial also suggest that these injections can prevent nonproliferative diabetic retinopathy (NPDR) disease progression.

A total of 402 participants were enrolled in 87 sites in the United States, Japan and Europe, and randomly assigned to 3 groups. The first group, after 3 monthly doses and one 8-week interval, received aflibercept injection every 16 weeks for the entire study duration of 100 weeks. The second group, after 5 monthly doses, received aflibercept every 8 weeks for one year, followed by PRN dosing in year 2. The third received sham injections with observation.

At week 52 and 100, significantly greater improvement in Diabetic Retinopathy Severity Scale (DRSS) level was achieved by both the aflibercept groups, with an over 70% reduced progression to proliferative diabetic retinopathy (PDR) or center-involved diabetic macular edema (CI-DME) as compared with the sham group. The risk of developing vision-threatening complications was also significantly lower.

A dose-dependent effect was seen at 1 year, with a 2-step greater improvement in DRSS in 79.9% of the eyes treated every 8 weeks and 62.2% of the eyes treated every 16 weeks. However, while the improvements in DRSS were maintained up to week 100 with injections at a fixed 16-week dosing interval, switching from fixed dosing every 8 weeks in the first year to PRN dosing in the second year was associated with decreased efficacy. The proportion of patients with 2-step or greater improvement in DRSS dropped to 50% and an increased rate of vision-threatening complications was observed.

“This finding suggests that, at a population level, to maintain DRSS improvement and minimize the risk of vision-threatening events, treatment at a fixed frequency (eg, 3 to 4 times annually) allows alteration of the natural history of disease progression in this patient population,” the authors wrote.

Although the current standard of care for severe NPDR is observation, they suggested that “implementing anti-VEGF therapy should be considered and discussed with these patients.”