Meeting News CoveragePerspective

VIBRANT study: Anti-VEGF outperforms laser treatment for BRVO

PHILADELPHIA — Aflibercept improved vision and reduced retinal thickness in eyes with branch retinal vein occlusion, according to a study presented here.

Julia A. Haller, MD, gave results from the VIBRANT study at Macula 2014.

“We see in the trial superiority of intravitreal aflibercept over laser treatment seen through week 24 in terms of visual acuity and anatomic outcomes,” Haller said. “The drug was well tolerated.”

The study included 91 patients who received intravitreal injections of Eylea (aflibercept, Regeneron) and 92 patients who underwent laser treatment.

Patients were randomized to undergo injections of aflibercept or laser treatment for 24 weeks.

Laser patients were eligible to undergo rescue aflibercept injection at 12 weeks. Patients in the aflibercept group received a mean 5.7 injections. Laser patients received a mean two injections.

Fifty-three percent of aflibercept patients and 27% of laser patients gained three or more letters at 24 weeks. The between-group difference was statistically significant.

Mean change in best corrected visual acuity was 17 letters in the aflibercept group and 6.9 letters in the laser group.

Central retinal thickness was reduced by a mean 280 µm in the aflibercept group and 128 µm in the laser group.
Quality-of-life scores were slightly higher in the aflibercept group than in the laser group.

The most common adverse events in the aflibercept group were typical of those commonly associated with intravitreal injections, Haller said.

Further results will focus on longer treatment intervals and on patients with nonperfusion and BRVO, she said.

Disclosure: Haller is a consultant for Regeneron.

PHILADELPHIA — Aflibercept improved vision and reduced retinal thickness in eyes with branch retinal vein occlusion, according to a study presented here.

Julia A. Haller, MD, gave results from the VIBRANT study at Macula 2014.

“We see in the trial superiority of intravitreal aflibercept over laser treatment seen through week 24 in terms of visual acuity and anatomic outcomes,” Haller said. “The drug was well tolerated.”

The study included 91 patients who received intravitreal injections of Eylea (aflibercept, Regeneron) and 92 patients who underwent laser treatment.

Patients were randomized to undergo injections of aflibercept or laser treatment for 24 weeks.

Laser patients were eligible to undergo rescue aflibercept injection at 12 weeks. Patients in the aflibercept group received a mean 5.7 injections. Laser patients received a mean two injections.

Fifty-three percent of aflibercept patients and 27% of laser patients gained three or more letters at 24 weeks. The between-group difference was statistically significant.

Mean change in best corrected visual acuity was 17 letters in the aflibercept group and 6.9 letters in the laser group.

Central retinal thickness was reduced by a mean 280 µm in the aflibercept group and 128 µm in the laser group.
Quality-of-life scores were slightly higher in the aflibercept group than in the laser group.

The most common adverse events in the aflibercept group were typical of those commonly associated with intravitreal injections, Haller said.

Further results will focus on longer treatment intervals and on patients with nonperfusion and BRVO, she said.

Disclosure: Haller is a consultant for Regeneron.

    Perspective

    Dr. Haller of Wills Eye Institute presented results from the VIBRANT study, a 24-week-long study that randomly assigned patients with macular edema secondary to BRVO to receive either monthly injections of aflibercept or focal laser followed by the option for rescue injections of aflibercept after 12 weeks. Visual acuities in the monthly injection group were significantly better than the laser followed by deferred rescue injections group, which again stresses the importance of early anti-VEGF interventions for treatment of macular edema secondary to BRVO, as also shown in the BRAVO trial (which evaluated prompt vs. deferred monthly injections of ranibizumab).
    Further studies will be needed to assess whether three monthly injections followed by every-other-month injections of aflibercept are non-inferior to monthly injections of ranibizumab, as in the VIEW trials, which found statistical equivalence between monthly ranibizumab and every-other-month aflibercept for treatment of neovascular AMD.

    • Andre J. Witkin, MD
    • Assistant professor of ophthalmology Tufts Medical Center, Boston

    Disclosures: Witkin has no relevant financial disclosures.

    See more from Macula Meeting