Visual and anatomical gains made with aflibercept monotherapy for polypoidal choroidal vasculopathy were maintained long term, according to a study looking at the second-year data of the PLANET trial.
“The trial confirms the 2-year effectiveness of using anti-VEGF monotherapy with aflibercept (Eylea, Regeneron) in treating a common subtype of AMD, which is polypoidal choroidal vasculopathy (PCV), based on the PLANET trial protocol,” Tien Wong, MD, PhD, professor and medical director at the Singapore National Eye Center and chairman of the Singapore Eye Research Institute, told Healio.com/OSN. “Using the PLANET protocol, only a small proportion of patients required ‘rescue’ photodynamic therapy.”
In the multicenter, double-masked, sham-controlled phase 3b/4 analysis, 137 patients in the aflibercept-only group and 147 in the aflibercept plus rescue therapy group completed 96 weeks of study.
Participants were given three monthly injections of aflibercept and were randomly assigned at week 12 to receive either 2 mg of aflibercept with sham PDT or aflibercept with active rescue PDT until week 96 if certain rescue criteria were met. Criteria for rescue required either a best corrected visual acuity worse than 73 letters with a BCVA gain from a baseline of less than 5 letters, or BCVA gain greater than or equal to 5 but less than 10 letters, new or persistent fluid on OCT and evidence of active polyps on indocyanine green angiography.
Overall, 17% of participants met rescue criteria, with 15.9% of patients in the aflibercept group and 18% of patients in the sham PDT group. Mean gain in BCVA was similar between the aflibercept-only group and the sham PDT group as well: 12.3 vs. 1.1 ETDRS letters, respectively.
“This is the first [trial] to show effectiveness of anti-VEGF monotherapy of a relatively longer period,” Wong said. “A significant proportion of patients have polyps at the end of 2 years, which means that the disease is controlled but the disease remains present and may cause problems in the future.” – by Eamon Dreisbach
Disclosures: Wong reports he receives grants from Novartis and Bayer; receives personal fees from Novartis, Bayer, Abbott, Allergan, Genentech, Roche and Pfizer; and is a consultant and member of the advisory board for Allergan, Bayer, Boehringer-Ingelheim, Genentech, Merck, Novartis, Oxurion and Roche. Please see the study for all other authors’ relevant financial disclosures.