Aflibercept Similar to Ranibizumab in Visual Acuity Improvements in VIEW Studies

Neovascular age-related macular degenerations (nAMD) patients receiving intravitreal aflibercept injections (IAI) showed similar improvements in all visual endpoints when compared to ranibizumab, according to a presentation at the 2017 American Society of Retina Specialists (ASRS) annual meeting.

Through weeks 52 to 96 in the integrated, phase 3 Vascular Endothelial Growth Factor (VEGF) Trap-Eye: Investigation of Efficacy and Safety in Wet Age-Related Macular Degeneration (AMD) (VIEW 2) studies, patients continued to receive the treatments assigned to them based on four dosing subgroups: ranibizumab 0.5 mg every month (Rq4), IAI 2 mg every month (2q4), 0.5 mg every month (0.5q4), or 2 mg every 2 months (2q8) following 3 initial monthly doses over the first 52 weeks.

“Approximately 50% of patients that were in the aflibercept treatment groups received treatment every 12 weeks during the second year of the VIEW studies,” Anthony Joseph, MD, of the Ophthalmic Consultants of Boston and New England Eye Center at Tufts Medical Center (pictured) said at the ASRS annual meeting in Boston. “Meanwhile, 42.5% of patients treated with ranibizumab received doses only every 12 weeks.”

The Rq4 group received the highest mean number of injections over 2 years at 16.5, followed by the IAI 0.5q4 group at 16.2, the IAI 2q4 group with 16.0, and 11.2 for the IAIA 2q8 group. Over the week 52 follow-up period, those averages were 4.7, 4.6, 4.1, and 4.2, respectively.

Among the four groups, visual acuity (VA) was maintained at a rate of 92% for the Rq4, IAI 2q4, and IAI 2q8 groups, while the IAI 0.5q4 group saw a 91% rate. Average best-corrected visual acuity (BCVA) gains were 7.9 (Rq4), 7.6 (IAI 2q4), 6.6 (IAI 0.5q4), and 7.6 (IAI 2q8) letters.

“Vision and anatomic improvements at week 52 were largely maintained in both less than or equal to 12-week and greater than 12-week dosing subgroups,” Joseph said.

Over the entire 96-week period, the original IAI 2q8 group received an average of 5.3 fewer injections while maintaining efficacy on par with ranibizumab.

“Retinal fluid and leakage on [fluorescein angiography] were the factors most associated with greater than 12-week dosing groups,” Joseph said. “Which results in higher odds of patients requiring more frequent treatments than those with a classic component.”

Some patients may receive treatment every 12 weeks with 2 mg IAI based on the assessments done by the treating physician, Joseph added.