Key Takeaways
- Switching from aflibercept 2 mg to aflibercept 8 mg maintained visual stability and improved retinal anatomy in patients with nAMD requiring frequent retreatment.
- Some patients experienced reduced injection burden, but early discontinuation rates were high and intraocular inflammation was linked to off-label drug preparation.
Switching patients with neovascular age-related macular degeneration (nAMD) from aflibercept 2 mg to aflibercept 8 mg was associated with modest anatomical improvements and stable visual outcomes in a real-world study of patients requiring frequent anti-VEGF retreatment, according to a study.
The prospective single-center study included 50 patients with nAMD requiring retreatment every 4 to 6 weeks despite prior anti-VEGF therapy. After switching to aflibercept 8 mg, distance-corrected visual acuity improved significantly through month 9 and remained stable at month 12. Central retinal thickness and central subfield thickness decreased early and remained improved.
Over 12 months, 34% of patients required 8 or fewer injections annually. However, 52% discontinued treatment early.
Intraocular inflammation occurred in 10 eyes and was linked to off-label aliquoted drug preparation. All cases resolved without permanent visual loss, and no further inflammatory events were reported after transition to on-label preparation. The researchers noted that the findings should be interpreted cautiously, given the exploratory design, lack of a comparator group, and high discontinuation rate.
Reference
Spartalis C, Ullrich M, Winkler S, et al. Prospective Real-World Outcomes After Switching to Aflibercept 8 mg in Neovascular Age-Related Macular Degeneration with High Treatment Burden. Ophthalmol Ther. 2026;doi: 10.1007/s40123-026-01394-1. Epub ahead of print. PMID: 42154394.
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