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Ingrid U Scott, Paul Van Veldhuisen, Michael S Ip, Barbara A Blodi; Comparison of the SCORE2 and LEAVO Trials of Anti-VEGF Treatment for Decreased Vision Attributable to Macular Edema due to Central or Hemi-retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1336.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the SCORE2 and LEAVO trial results of treatment with aflibercept versus bevacizumab for decreased vision attributable to macular edema due to central retinal vein occlusion (CRVO) or hemi-retinal vein occlusion (HRVO) (HRVO in SCORE2 only).
The primary outcome in both trials was mean change from baseline in visual acuity letter score (VALS), with the primary outcome time point for SCORE2 at week 24 (6 months) and LEAVO at week 100 (2 years). A 4-week anti-VEGF treatment schedule was implemented in both trials through Week 16, after which the protocol-defined treatment plans differed.
LEAVO included only patients with CRVO, while 16% of SCORE2 participants were diagnosed with HRVO. While SCORE2 eligibility criteria were designed to exclude ischemic cases, 12% of the CRVOs in LEAVO were ischemic. The proportion of participants with a duration of macular edema <3 months at baseline was 67% in SCORE2 compared to 87% in LEAVO. Mean baseline VALS was 50 in SCORE2 and 54 in LEAVO. The mean improvement from baseline to week 24 in VALS was 18.9 for eyes randomized to aflibercept and 18.6 for eyes randomized to bevacizumab in SCORE2, compared to 13.4 and 10.4 letters, respectively, in LEAVO. At week 100, mean improvement from baseline in VALS was 14.0 for eyes originally randomized to aflibercept and 14.5 for eyes originally randomized to bevacizumab in SCORE2, compared to 15.1 and 9.8, respectively, in LEAVO. LEAVO had a mean of approximately 1 fewer anti-VEGF treatment compared to SCORE2 at week 24, and a mean of 4 fewer treatments at week 100.
Results from SCORE2 and LEAVO demonstrate the effectiveness of aflibercept and bevacizumab for decreased vision attributable to macular edema due to CRVO or HRVO. Aflibercept was associated with a mean VALS improvement over bevacizumab of 3 letters at week 24 and over 5 letters at week 100 in LEAVO, but not in SCORE2. This difference, and differences between the trials in the magnitude of VALS improvements over baseline, may be due to fewer treatments in LEAVO compared with SCORE2. Differences between the trial outcomes may also be associated with differences in eligibility criteria and baseline characteristics.
This is a 2020 ARVO Annual Meeting abstract.
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