Bevacizumab, Aflibercept Compared for Neovascular AMD

MONDAY, Dec. 5, 2022 (HealthDay News) — For patients with neovascular age-related macular degeneration (nvAMD), eyes treated with bevacizumab require more injections than those treated with aflibercept, and those receiving aflibercept are more likely to be weaned off treatment, according to a study published online Nov. 22 in the Journal of Clinical Investigation.

Xuan Cao, Ph.D., from the Wilmer Eye Institute at Johns Hopkins University School of Medicine in Baltimore, and colleagues examined whether the choice of therapy influences outcome in a “treat-and-extend-pause/monitor” approach, which can be used to wean nvAMD patients off antivascular endothelial growth factor therapy. Data were included for 122 eyes of 106 patients with nvAMD who underwent three consecutive monthly injections with aflibercept or bevacizumab (70 and 52 patients, respectively) followed by a treat-and-extend protocol. Eyes that were stable 12 weeks from their previous treatment were given a six-week trial of holding additional treatment, followed by monitoring every quarter. For worsening vision, clinical exam, or optical coherence tomography findings, treatment was resumed.

The researchers found that the eyes receiving bevacizumab had similar vision to those receiving aflibercept at the end of one year but required more injections (8.7 ± 0.3 versus 7.2 ± 0.3). The likelihood of being weaned off treatment was almost threefold higher for eyes treated with aflibercept (43 versus 15 percent) compared with eyes treated with bevacizumab at the end of one year.

“These results provide additional evidence that aflibercept and bevacizumab should not be considered interchangeable when treating AMD,” a coauthor said in a statement.

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