Number of Anti-VEGF Injections Correlated with Change in BCVA

Despite the varying durability of the different anti-vascular endothelial growth factor (VEGF) agents, there is a positive and clinically meaningful correlation between the number of intravitreal injections in 12 months and the change in mean best-corrected visual acuity (BCVA), according to a study published as part of the American Society of Retina Specialists 2020 Virtual Annual Meeting.

Researchers reviewed level 1 evidence for currently approved anti-VEGF injection agents and those likely to undergo review by regulatory authorities, encompassing 23 different injection regimens. Researchers assessed baseline Early Treatment Diabetic Retinopathy Study (ETDRS) Letters, mean number of injections over a 12-month period, and change in ETDRS Letters over 12 months.

A total of 6,860 eyes from nine randomized, controlled trials were included. Mean number of injections over 12 months across the studies was 9.4. Eight patients (31.6%; n=2,165) received ranibizumab every four weeks or pro-re-nata (PRN), six (28.6%; n=1,962) received aflibercept every four or eight weeks, four (15.4%; n=1,059) received abicipar every eight or 12 weeks, three (15.8%; n=1,088) received brolucizumab every eight or 12 weeks based on clinical activity, and two (8.7%) received bevacizumab every four weeks or PRN. Mean change in ETDRS Letters was 7.86. The correlation coefficient between the number of injections and mean change in ETDRS Letters was 0.60. Although the agents had different durability, there was a positive and clinically meaningful correlation between the number of injections in 12 months and change in BCVA.

“Retina specialists should utilize this data in real-world practice, while considering the impact of treatment burden on [patients with wet] AMD,” the researchers concluded.

Komati R, Hariprasad SM, Eichenbaum DA, et al. Treatment Burden and Vision Analysis of Anti-VEGF Therapies for the Treatment of Neovascular AMD. Presented during the ASRS 2020 Virtual Annual Meeting, July 24-26, 2020.