Abstract
Aim: To evaluate the real utilization of ranibizumab and aflibercept in the daily management of patients with neovascular age-related macular degeneration (nAMD) treated at the Eye Clinic of Campania University L.Vanvitelli. Background: Therapy with anti-vascular endothelial growth factor represents the gold standard in wet age-related macular degeneration. There are nonreal life italian studies of this therapy in the literature. Objective: To analyze in our sample the post-therapy variations of best-corrected visual acuity (BCVA) and central retinal thickness (CRT) observed at the end of a 12-month follow-up period. Methods: This real-life study analyzes 109 patients that underwent monthly checks for the first 4 months and then every 2 months until the end of the 12-month follow-up. The sample was first analyzed in its entirety, subsequently subdivided into 3 groups based on baseline BCVA, age, and the number of intravitreal injections performed, in order to identify possible predictive elements of the anti-VEGF response. Results: On average, patients underwent 4.16 ± 1.58 intravitreal anti-VEGF injections in 1 year. At the end of the 12-month follow-up, the patients’ average BCVA increased from 33.01 letters to 33.75 letters (+0.74 ± 9,4 letters), while the average CRT decreased from 346.86 µm to 265.39 µm (-81.47 ± 121 µm). Conclusion: The study shows the efficacy of anti-VEGF therapy in the stabilization of BCVA in nAMD, confirming the differences in visual outcomes compared to clinical trials, mainly for economic-organizational reasons.
Highlights
The study shows the efficacy of anti-VEGF therapy in the stabilization of best-corrected visual acuity (BCVA) in neovascular age-related macular degeneration (nAMD), confirming the differences in visual outcomes compared to clinical trials, mainly for economic-organizational reasons
Aflibercept (Eylea, Regeneron Pharmaceuticals, Inc.) was approved by the Food and Drug Administration (FDA) in 2011 after demonstrating its non-inferiority in terms of best-corrected visual acuity (BCVA) and safety profile compared to ranibizumab in clinical trials VIEW 1 and VIEW 2 [11 - 13]
Pegabtanib, which is the first drug approved by the FDA, is currently no longer used for poor visual outcomes compared to other anti-VEGFs
Summary
The three anti-VEGFs mostly used in the management of nAMD worldwide are ranibizumab, aflibercept, and bevacizumab. Aflibercept (Eylea, Regeneron Pharmaceuticals, Inc.) was approved by the Food and Drug Administration (FDA) in 2011 after demonstrating its non-inferiority in terms of best-corrected visual acuity (BCVA) and safety profile compared to ranibizumab in clinical trials VIEW 1 and VIEW 2 [11 - 13]. Pegabtanib, which is the first drug approved by the FDA, is currently no longer used for poor visual outcomes compared to other anti-VEGFs. The three main treatment regimes currently used in the management of nAMD are fixed regime according to the labelling, pro re nata (PRN), and ‘treat and extend’. Therapy with anti-vascular endothelial growth factor represents the gold standard in wet age-related macular degeneration. There are nonreal life italian studies of this therapy in the literature
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