ELU Study: Aflibercept decreases the number of follow-up and intravitreal injection visits compared with ranibizumab, in patients with exudative (wet) age-related macular degeneration

摘要

Purpose : The efficacy and safety of Ranibizumab and Aflibercept are comparable and well known in (wet) age related macular degeneration (AMD) treatment. Considering their same level of efficacy, we rather chose one molecule as first line, because of its incidence in decreasing the number of follow-up (FU) and intravitreal injection (IVI).The main objective of this study was to compare the number FU and IVI visits in patients with AMD, successively treated with Ranibizumab and Aflibercept. Methods : We retrospectively enrolled 33 patients (38 eyes) with AMD (mean age 77?±7.7) treated first with Ranibizumab (group1), and switched to Aflibercept (group 2).For each patient, we compared the number of FU and IVI visits for each treatment period. Visual Acuity (VA) evolution was analyzed as a secondary criteria as well as the reason for a??switchinga??. Results : The median (min; max) numbers of FU and IVI visits were respectively 16 (10; 30) and 11 (5; 20) in group 1 (Ranibizumab), and 16 (13;18) and 11 (6; 14) in group 2 (Aflibercept ).The median numbers of monthly FU were respectively 1.0 (0.81; 1.49) versus 0.79 (0.67; 0.86) in group 1 and group 2. This number was significantly lower with Aflibercept (p(W)=0.0005 and p(BM)=0.0002).The median number of IVI by treatment period was 0.67 (0.55; 0.90) in group 1 and 0.55 (0.45; 0.67) in group 2. This number of IVI visits also significantly decreased during the Aflibercept treatment (group 2) (p(W)=0.0049 and p(BM)=0.0041). The VA delta, between initial and final visits, was calculated for each group and compared. The mean (+/- SD) evolution of VA was 0.0066?±0.2377 in group 1 versus 0.0305?±0.1792 in group 2, VA evolution was similar in both groups (p(W)=0.8113 and p(BM)=0.7886). Whatever the reason for a??switchinga?? from Ranibizumab to Aflibercept (loss of efficacy, tachyphylaxis, tolerance problems), there was no incidence on the VA evolution in time. Conclusions : Our results showed that, Aflibercept could significantly reduce the number of FU and IVI visits, with the same efficacy than Ranibizumab. This decrease in visit number could improve patientsa?? quality of life and reduce surgical risk by reducing the number of injections. Randomized prospective studies on larger scales are necessary to confirm these results This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.