Higher dose aflibercept may improve outcomes after suboptimal outcomes with standard dosing

Eyes that respond suboptimally to standard-dose aflibercept may experience improved outcomes and decreased treatment burden with higher dose (HD) aflibercept, according to a study.

In this retrospective analysis, 318 eyes of 288 patients that were switched from aflibercept 2 mg to aflibercept HD (3 mg to 4 mg) were included. Of the eyes with neovascular age-related macular degeneration (nAMD), 59 had clinically significant disease activity on monthly therapy (AMT) (injection interval ≤35 days) and 147 had clinically significant increased activity on extension (IAE) (injection interval >36 days). Of the eyes with DME, 50 had AMT and 62 had IAE.

A switch to aflibercept HD 3 mg was made in 73% and 58% of the nAMD patients with AMT and IAE, respectively, and in 49% and 68% of DME patients, respectively.

The mean best visual acuity improved significantly with AMT and was maintained with IAE. A significant decrease in central subfield thickness was observed as well as an increase or stabilization in mean injection intervals.

Reference
Nielsen JS, Roberts CL, Saggau DD, et al. High-Dose Aflibercept for Neovascular AMD and DME in Suboptimal Responders to Standard-Dose Aflibercept. J Vitreoretin Dis. 2023;7(2):116-124. doi: 10.1177/24741264221150345. PMID: 37006663; PMCID: PMC10037750.