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Clinical Trial
. 2017 Nov;31(11):1582-1588.
doi: 10.1038/eye.2017.108. Epub 2017 Jun 16.

Second-year visual acuity outcomes of nAMD patients treated with aflibercept: data analysis from the UK Aflibercept Users Group

H Almuhtaseb  1   2 , R L Johnston  3 , J S Talks  4 , A J Lotery  1   2
Affiliations
Clinical Trial

Second-year visual acuity outcomes of nAMD patients treated with aflibercept: data analysis from the UK Aflibercept Users Group

H Almuhtaseb et al. Eye (Lond). 2017 Nov.

Abstract

PurposeTo audit the visual acuity (VA) outcomes achieved at the end of year two in 17 UK centres, which followed the year 1 VIEW protocol in year 1, but a variable approach in year 2 for aflibercept for neovascular macular degeneration (nAMD).Patients and methodsRetrospective data analysis, from an electronic medical record, of a consecutive series of treatment-naive nAMD patients who received aflibercept for 2 consecutive years, having followed the VIEW protocol in year one, defined as eyes having received 7 or 8 injections from baseline.ResultsThe mean number of intravitreal injections (IVI)s during year 2 was 3.7 in 1180 eyes (1083 patients). The mean baseline VA of the whole cohort was 56.3 ETDRS letters, improving to 61.3 at 1 year (+5) and 59.1 (+2.8) at the end of year 2. The mean VA letter score at the end of year 2, stratified by number of IVIs into three groups was as follows: group A, 57.3 (gain of +1.7) (44% of eyes (</=3 IVIs)); group B, 59.8 (+3.8) (34% of eyes (4-5 IVIs)); group C, 61.7 (+3.7) (22% of eyes (>/=6 IVIs)). Even though there were VA gains in the three groups over the 2-years, there was a drop in VA in year one to two. Eyes that received >/=6 IVIs (group C) had a smaller reduction of VA during year 2 than those which received </=3 IVIs (group A) (P=0.0014).ConclusionsProviding a higher number of injections after a Q8 regime in year 1 results in higher VA gains in year 2 of treatment.

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Conflict of interest statement

Medisoft and Newcastle Upon Tyne Hospitals NHS Foundation Trust received support for the data extraction and analysis from Bayer. Bayer were not involved in the data collection, analysis or writing of this paper. The authors have received travel bursaries and attended advisory boards for Bayer, Novartis and Allergan. RLJ was the Medical Director of Medisoft Limited, the Electronic Medical Record Supplier to all the sites contributing to this study.

Figures

Figure 1
Figure 1
During year one of treatment patients followed the VIEW 1 and 2 Clinical Trials’ protocol in which there were three loading IVIs (Q4W) followed by an IVI every other month.
Figure 2
Figure 2
Mean VA (ETDRS) over time since the first IVI. A mean gain of +2.8L was observed during the 2-year treatment period. A mean gain of +5L was observed in year 1. A mean loss of -2.2L was observed in year 2, when VA at week 104 was compared to VA at end of year 1.
Figure 3
Figure 3
The distribution of IVIs in year 2, patients having received 7–8 IVIs in year 1, following the VIEW protocol. In year 2, treatment regimens varied per centre.
Figure 4
Figure 4
Mean VA over time stratified by # of IVIs in year 2.
See this image and copyright information in PMC

References

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