Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 18;13(2):252-256.
doi: 10.18240/ijo.2020.02.08. eCollection 2020.

Impact of switching from ranibizumab to aflibercept on the number of intravitreous injection and follow up visit in wet AMD: results of real life ELU study

Frederic Queguiner  1 , Kristina Bezirganyan  1 , Jean Christophe Courjaret  1 , Laurence Curel  1 , Guillaume Penaranda  2 , Maud Righini Chossegros  1
Affiliations

Impact of switching from ranibizumab to aflibercept on the number of intravitreous injection and follow up visit in wet AMD: results of real life ELU study

Frederic Queguiner et al. Int J Ophthalmol. .

Abstract

Aim: To study if one of the two molecules could lead to a lower number of follow up visits and intra-vitreous injection (IVI) with the same efficacy.

Methods: ELU (or "elected" in French) study is a retrospective study conducted in real life in patients presenting suboptimal response after ranibizumab IVI (phase 1) and secondary switched to aflibercept (phase 2). The number of follow up visits and IVI were compared in both phases. Visual acuity (VA) evolution and "switching" reasons were secondary analyzed.

Results: We retrospectively included data of 33 patients (38 eyes) with age-related macular degeneration (AMD; mean age: 77±7.7y). The number of monthly follow up visits [median (Q1; Q3)]: was significantly lower with aflibercept (phase 2), respectively 1.0 (0.81; 1.49) visits in phase 1, versus 0.79 (0.67; 0.86) visits in phase 2. The median number of monthly IVI also significantly decreased in phase 2, respectively 0.67 (0.55; 0.90) IVI in phase 1, versus 0.55 (0.45; 0.67) IVI in phase 2. The mean VA evolution (VA final-VA initial) was similar in both phases, (P>0.05). Whatever the reason for "switching" (loss of efficacy, tachyphylaxis, tolerance problems), there was no incidence on VA evolution over the time.

Conclusion: Our results show that switching from ranibizumab to aflibercept in "suboptimal" patients significantly reduce the number of follow up visits and IVI, with a comparable efficacy. This decrease in visit number could improve patients' quality of life and reduce surgical risk by reducing the number of injections.

Keywords: aflibercept; anti-VEGF; follow up visit; intravitreal injection; ranibizumab; visual acuity; wet age-related macular degeneration.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Comparison of VA evolution (delta VA=VA final-VA initial), measured by ETDRS for each phase.
See this image and copyright information in PMC

References

    1. Rein DB, Wittenborn JS, Zhang X, Honeycutt AA, Lesesne SB, Saaddine J, Vision Health Cost-Effectiveness Study Group Forecasting age-related macular degeneration through the year 2050: the potential impact of new treatments. Arch Ophthalmol. 2009;127(4):533–540. - PubMed
    1. Wong T, Chakravarthy U, Klein R, Mitchell P, Zlateva G, Buggage R, Fahrbach K, Probst C, Sledge I. The natural history and prognosis of neovascular age-related macular degeneration. Ophthalmology. 2008;115(1):116–126.e1. - PubMed
    1. Brown DM, Michels M, Kaiser PK, Heier JS, Sy JP, Ianchulev T, ANCHOR Study Group Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology. 2009;116(1):57–65.e5. - PubMed
    1. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY, MARINA Study Group Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–1431. - PubMed
    1. Nguyen CL, Oh LJ, Wong E, Wei J, Chilov M. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration: a Meta-analysis of randomized controlled trials. BMC Ophthalmol. 2018;18(1):130. - PMC - PubMed

LinkOut - more resources