BOSTON — Long-term treat-and-extend anti-VEGF therapy maintains vision in some patients, even after 8 years and more than 50 injections, according to a study presented here
“Consistent use of anti-VEGF therapy can provide long-term maintenance of vision in patients with neovascular AMD in a typical retina practice,” David Adrean, MD, said in a paper presentation at the American Society of Retina Specialists meeting.
For the 71 patients with neovascular age-related macular degeneration who had received at least 50 anti-VEGF injections, the inclusion criteria were broad and more relevant to clinical practice, Adrean said. Patients with good initial vision, poor initial vision, retinal pigment epithelium tears, subretinal hemorrhage and large choroidal neovascularization were all included.
Treatment was switched among Lucentis (ranibizumab, Genentech), Eylea (aflibercept, Regeneron) and Avastin (bevacizumab, Genentech), depending on physician judgment. A total of 4,493 anti-VEGF injections were administered over 6,617 patient-months, with the mean time to the 50th injection being about 6 years and the mean total follow-up being 8 years. At the 51st injection, the interval between injections ranged between 4 and 12 weeks. At the last visit, the mean interval between injections was 6.4 weeks.
Mean gains in visual acuity were statistically significantly better than initial values at both the 51st visit and the final visit (both P < .001): 20/80 at first visit, 20/50 at 51st injection and 20/50 at final follow-up.
“Probably one good reason for this population to have good vision results is that patients with extensive subfoveal geographic atrophy or fibrovascular scarring typically did not require 50 or more injections to achieve stabilization of the choroidal neovascular membrane disease process,” Adrean said. – by Patricia Nale, ELS
Adrean SD, et al. Results of chronic long-term therapy inpatients receiving 50 or greater anti-VEGF injections with neovascular AMD managed by treat-and-extend therapy. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.
Adrean and colleagues report receiving grant funding from Allergan, Genentech, Ophthotech, Regeneron and SciFluor.