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Melina Cavichini Cordeiro, Varsha Alex, Fritz Gerald P Kalaw, Sumit Singh, Lingyun Cheng, William R Freeman; Evaluating the durability of extended aflibercept treatment regimens in patients with resistant CNVs.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1335 – F0169.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluating the efficacy of every 6-or-8-week aflibercept extension regimen in resistant Choroidal Neovascularization (CNV)s requiring monthly treatment.
This was a retrospective, cross-sectional study. Patients who visited the Retina clinic with a diagnosis of CNV due to AMD requiring escalating regimen and needing monthly aflibercept to control disease were reviewed. There were total of 60 eyes which were included. Subjects received either regular (low) dose aflibercept (A/L- 2 mg) or high dose aflibercept (A/H- 4 mg) injections every 4 weeks initially, until their macular Optical Coherence Tomography (OCT)s were dry, and they were then extended to either every 6-or-8-week injections. The durability of extended intervals was monitored by the reappearance of Intra- or Sub- Retinal Fluid (IRF/SRF) in OCTs which had completely dry macula at the start. Statistical analysis was done using Cox regression model.
Analysis performed using dose regimen as a stratum, after adjusting for age and sex, revealed that the dose regimen (High Vs Regular) prior to extension was a significant predictor with high dose (4 mg) showing a longer time to relapse, p < 0.04. There was reduced hazard of recurrence (OR A/H vs. A/L = 0.507, p= 0.0305). Also, the longer the duration of monthly aflibercept before extension, the shorter the time to relapse, p=0.0023.
Resistant CNV requiring monthly aflibercept therapy could be successfully extended to every 6 - 8 weeks. Eyes which received high dose aflibercept injections as the extension regimen took longer to fail and had less disease relapse than the eyes on regular dose.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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