Real-world data on aflibercept 8 mg (Eylea HD; Regeneron), presented this week at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Salt Lake City, Utah, suggest that patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) may require less frequent injections while maintaining or improving vision.
The findings are based on electronic health record data from the IRIS Registry and the Vestrum Health Retina Databases, including nearly 40,000 eyes treated with Eylea HD in clinical practice. The analyses looked at both treatment-naïve patients and those who switched from other anti-VEGF therapies, primarily aflibercept 2 mg (Eylea; Regeneron) or faricimab (Vabysmo; Genentech).
In previously treated patients with DME, switching to Eylea HD led to a mean extension of injection intervals by approximately 2 to 3 weeks. Among patients who had been receiving injections every 4 to 6 weeks before the switch, the interval increased by 20 to 24 days. Those with 6-week to 8-week intervals saw increases of 13 to 16 days. Similar results were reported in the nAMD cohort, with dosing intervals extended by 16 to 21 days in the 4-week to 6-week group and by 12 to 16 days in the 6-week to 8-week group.
In treatment-naïve patients, early visual improvements were noted. Among DME patients with poor baseline vision (20/50 or worse), visual acuity improved by an average of 7.9 to 9.6 letters within 90 days of starting treatment. Patients with better starting vision showed minimal change, indicating disease stabilization. Results were similar for treatment-naïve nAMD patients, with vision gains of 4.4 to 4.5 letters in those with poor vision at baseline, and largely stable vision in those with better initial acuity. Post–loading phase injection intervals in treatment-naïve patients averaged roughly 63 to 69 days, suggesting a potential for 8-week or longer dosing schedules in some patients after the initial 3 injections.
The most common adverse events reported in patients treated with Eylea HD in clinical trials were cataract, increased intraocular pressure, conjunctival hemorrhage, and eye discomfort. No new safety signals were identified in the real-world studies. RP