Intravitreal sirolimus with adjunct aflibercept may be beneficial in wet AMD
Use of a combination of intravitreal sirolimus with adjunct aflibercept in patients with persistent, exudative age-related macular degeneration (wet AMD) did not result in a statistically significant difference in mean central subfield thickness change compared with patients treated with aflibercept alone, according to a study. However, the combination treatment appeared to have the potential for anatomical benefits in these patients.
In this prospective, randomized controlled trial, patients with persistent wet AMD were treated with alternating monthly intravitreal sirolimus and aflibercept (n = 10) or aflibercept monotherapy every 2 months (n = 10) over the course of 36 weeks
Prior to the study, participants had an average of 38 anti-VEGF injections.
In the combination group, there was a decrease of 54.0 μm in the mean central subfield thickness and a mean visual acuity improvement of 2.5 ETDRS letters compared with a decrease of 0.1 μm (P = 0.28) and an improvement of 0.8 ETDRS letters (P = 0.42), respectively, in the control group.
No serious ocular adverse events were reported in either group. In the combination group, there were 3 serious systemic events (hospitalizations due to pancreatitis, pneumonia, and worsening hypertension).
Rowe LW, Minturn RJ, Burgett LA, et al. Intravitreal sirolimus with adjunct aflibercept versus aflibercept monotherapy for persistent, exudative age-related macular degeneration: a pilot study. Int J Retina Vitreous. 2023;9(1):1. doi: 10.1186/s40942-022-00437-6. PMID: 36604756; PMCID: PMC9814330.