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Manuel Casselholm de Salles, Urban Amrén, Anders P Kvanta, David L Epstein; Patients with Central Retinal Vein Occlusion require fewer injections when treated with aflibercept compared to ranibizumab using a treat-and-extend regimen: A prospective double-masked study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2960.
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Vascular endothelial growth factor (anti-VEGF) inhibitors are potent treatment options in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO). Previous reports have suggested that aflibercept may have a longer duration compared to ranibizumab. However, there are no comparative trials on injection frequency with the two drugs in CRVO patients. We hypothesize that aflibercept has a longer duration than ranibizumab and that patients treated with aflibercept need fewer injections than subjects treated with ranibizumab when using a treat-and-extend regimen.
This was a prospective, randomized, double masked trial. Forty-five patients with treatment naïve CRVO and ME were randomized (1:1) to receive intravitreal injections with aflibercept or ranibizumab given in a treat-and-extend regimen. The primary outcome measure was the number of injections needed during the study period of 18 months. After 3 initial loading doses the treatment intervals were extended by 2-week intervals to a maximum of 12 weeks. Intervals were shortened by 2 weeks if ME recurred, as defined by intraretinal or subretinal fluid and central retinal thickness (CRT) of > 300 μm, (Cirrus Optical Coherence Tomography).
Patients treated with aflibercept needed significantly fewer intravitreal injections compared to patients receiving ranibizumab (p=0.0017). There was no significant difference between the groups regarding visual acuity or CRT.
Patients with ME secondary to CRVO need significantly fewer intravitreal injections over an 18 month period when treated with aflibercept compared to ranibizumab when using a treat-and-extend regimen.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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