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Maria Cristina Citu, Roxanne R Crosby-Nwaobi, Maria Eleftheriadou, Clara Vazquez-Alfageme, Luke Nicholson, Sobha Sivaprasad, Philip Hykin, Robin D Hamilton; Real-world one year outcomes of a switch to aflibercept from ranibizumab in neovascular age related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3342. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the 12 months anatomical and visual outcomes of a switch from Eylea to Aflibercept. Due to its cost-effectiveness, in 2013, the National Institute of Health and Care Excellence (NICE) recommended the use of aflibercept (Eylea, Bayer) as first line treatment for neovascular Age-Related Macular Degeneration (nAMD). Following this recommendation, all patients receiving ranibizumab (Lucentis, Novartis) from Moorfields Eye Hospital were offered a switch to aflibercept.
A retrospective study on consecutive patients who switched from ranibizumab to aflibercept from October 2013 till November 2013. A minimum of 12 ± 1 month of follow-up was required. Visual acuity (VA)was collected at baseline and at the end of the follow-up. Optical Coherence Tomography (OCT) images, acquired with a single device (Topcon 3D-2000, Topcon) were analysed by a single grader. Central subfield thickness (CST), presence of intra retinal fluid (IRF), sub retinal fluid (SRF) and pigment epithelium detachment (PED) were collected.
110 patients were included in the study. The mean age was 78.5±7.0 with 59.1% of them females. The mean number of previous ranibizumab injections was 8.00 (95% CI 7.58-8.42). The mean number of aflibercept injections was 6.44 (95% CI 6.15-6.72). At baseline, the mean VA was 64.01 letters (95% CI 61.21-68.80) and CST was 271.79µm (95% CI 258.63-284.95). At 12 months post switch, mean VA was 63.05 letters (95% CI 59.80-66.31) and CST was 246.33µm (95% CI 235.03-257.62). The difference in CST from baseline was statistically significant (p<0.001) but not for VA (p=0.3249). The difference in VA after 12 months was not significantly associated with presence of IRF (p=0.2983), SRF (p= 0.7383) and PED (0.9171) at baseline. The presence of IRF was associated with worse VA at baseline (p<0.001) and at 12 months (p<0.001).
The switch from ranibizumab to aflibercept in nAMD due to cost-effectiveness maintained the VA and achieved a significant reduction in CST at 12 months of treatment in our cohort of patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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