Abstract
Purpose :
To examine the effect of intravitreal aflibercept injection 8 mg on visual and anatomic outcomes in patients with neovascular age-related macular degeneration (nAMD).
Methods :
In CANDELA, treatment-naïve patients with nAMD were randomized to receive 3 monthly doses of either aflibercept 2 mg (n=53) or aflibercept 8 mg (n=53) followed by doses at Weeks 20 and 32. This post hoc analysis was conducted to assess the proportion of eyes without intraretinal fluid (IRF), subretinal fluid (SRF), or sub-retinal pigment epithelium (RPE) fluid in the central subfield at Weeks 16 and 44, proportion of eyes that achieved >239 µm reduction in central subfield thickness (CST), ≥15-letter gain, best-corrected visual acuity (BCVA) ≥20/40, and BCVA ≥20/20 at Week 44, and proportion of eyes with baseline BCVA <20/40 that achieved ≥10- and ≥15-letter gains at Week 44.
Results :
For eyes receiving aflibercept 8 mg versus those receiving 2 mg, the proportion of eyes without IRF, SRF, or sub-RPE fluid in the central subfield was 38% versus 19% at Week 16, respectively (nominal P=0.031), and 25% versus 11% at Week 44 (nominal P=0.076). At Week 44, a greater proportion of eyes had >239 µm reduction in CST with aflibercept 8 mg versus 2 mg (27% vs 20%). Additionally, at Week 44, a greater proportion of eyes in the aflibercept 8 mg versus 2 mg group gained ≥15-letters (33% vs 14%), achieved BCVA ≥20/40 (61% vs 49%) and achieved BCVA ≥20/20 (10% vs 2%). Conversely, a smaller proportion of eyes had vision loss/no BCVA change at Week 44 (20% vs 27% in the aflibercept 8 mg and 2 mg groups, respectively). Among eyes with baseline BCVA <20/40, a greater proportion in the aflibercept 8 mg versus 2 mg group gained ≥10 letters (65% vs 47%) and ≥15 letters (43% vs 18%) at Week 44.
Conclusions :
Eyes treated with aflibercept 8 mg achieved improved visual and anatomical outcomes, suggesting potential therapeutic benefit compared with aflibercept 2 mg in patients with nAMD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.