Twelve-Month Outcomes of "Treat and Extend" aflibercept Therapy for Neovascular Age-Related Macular Degeneration

Abstract

Purpose : To report the 12-month outcomes of aflibercept therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice.

Methods : Treatment-naïve eyes that were receiving only aflibercept for nAMD under a treat and extend regime as reported by practitioners were extracted from the Fight Retinal Blindness observational registry. The primary outcome measures were change in visual acuity (VA) over 12 months and the number of injections and visits.

Results : Data from 116 eyes from 110 patients starting aflibercept therapy between November 2012 and May 2014 for nAMD with 12-month follow-up under a treat and extend regime were included in the analysis. Mean VA increased by +9.5 logMAR letters from 59.7 letters at time of first injection to 69.2 letters at 12 months. Mean VA gains predominantly occurred during the initial 6 months of treatment, increasing by +9.1 letters in the first 6 months compared with +0.4 in the second 6 months. The proportion of eyes with VA > 20/40 increased from 34% at time of first injection to 67% after 12 months of treatment. The proportion of eyes with VA < 20/200 decreased from 16% at time of first injection to 10% after 12 months of treatment. 97% of eyes receiving treatment avoided a vision loss of ≥ 15 letters. There was an overall mean of 7.3 injections over the 12 months with 4.6 injections in the first 6 months and 2.7 in the second 6 months of treatment. The mean number of visits was 7.8 over the 12 months, 4.8 visits in the first 6 months and 3.0 in the second 6 months of treatment. An injection was received in 86% of all visits within the 12-month follow-up period.

Conclusions : These data indicate that eyes treated with aflibercept in routine clinical practice under a treat and extend regiment achieve good visual outcomes for the first 12 months while decreasing the burden of treatments and clinic visits compared to the pivotal monthly injection trials. Longer term outcomes of aflibercept treatment with this regimen are being collected. Show more