Comparison of two different treat-and-extend protocols with aflibercept in wet age-related macular degeneration.
Aged
Aged, 80 and over
Angiogenesis Inhibitors
/ administration & dosage
Drug Administration Schedule
Female
Humans
Intravitreal Injections
Macula Lutea
/ drug effects
Male
Prospective Studies
Receptors, Vascular Endothelial Growth Factor
/ administration & dosage
Recombinant Fusion Proteins
/ administration & dosage
Treatment Outcome
Visual Acuity
/ drug effects
Wet Macular Degeneration
/ drug therapy
aflibercept
anti-vascular endothelial growth factor
treat-and-extend regimen
wet age-related macular degeneration
Journal
Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
10
05
2019
accepted:
28
07
2019
pubmed:
20
8
2019
medline:
10
2
2021
entrez:
18
8
2019
Statut:
ppublish
Résumé
To optimize the aflibercept treat-and-extend protocol in wet age-related macular degeneration (wAMD). A prospective randomized clinical trial consisting of 52 eyes from 52 patients with treatment-naïve wAMD. Patients received three monthly aflibercept injections and were then randomized 1:1 to two different dosing protocols. In treat-and-extend protocol with moderate extensions (T&Em), after the loading phase the treatment interval was extended 1 week at a time up to 12 weeks and then by 2 weeks up to 16 weeks. In treat-and-extend protocol with rapid extensions (T&Er), the interval was first extended to 8 weeks and then by 2 weeks at a time up to 16 weeks. Main outcome measure was the number of given aflibercept injections. Fifty (96%) patients completed the 1-year follow-up. Patient and ophthalmic baseline variables were comparable between the study groups. At 1 year, central subfield macular thickness reduced by 194.3 ± 153.6 μm in T&Em protocol, compared with 194.2 ± 176.6 μm in T&Er (p = 0.997). Eyes with T&Em gained 10.3 ± 11.5 letters from baseline and eyes with T&Er 11.4 ± 10.6 letters (p = 0.434), and dry macula was observed in 72% of eyes with T&Em compared to 68% with T&Er (p = 0.758). At 1 year, the treatment interval was 8.5 ± 2.2 weeks in T&Em and 10.3 ± 2.8 weeks in T&Er (p = 0.017), and the total number of injections 8.64 ± 1.58 and 6.96 ± 0.79, respectively (p < 0.001). In the rapid extensions protocol, 48% of eyes reached a 12-week treatment interval or beyond at 1 year. At one year, the anatomical and functional responses were comparable between the moderate and rapid extensions protocols, with fewer aflibercept injections in the rapid extension protocol.
Substances chimiques
Angiogenesis Inhibitors
0
Recombinant Fusion Proteins
0
aflibercept
15C2VL427D
Receptors, Vascular Endothelial Growth Factor
EC 2.7.10.1
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
267-273Informations de copyright
© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
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