Second-year visual acuity outcomes of nAMD patients treated with aflibercept: data analysis from the UK aflibercept users group
Open accessAbstract
PurposeTo audit the visual acuity (VA) outcomes achieved at the end of year two in 17 UK centres, which followed the year 1 VIEW protocol in year 1, but a variable approach in year 2 for aflibercept for neovascular macular degeneration (nAMD).Patients and methodsRetrospective data analysis, from an electronic medical record, of a consecutive series of treatment-naive nAMD patients who received aflibercept for 2 consecutive years, having followed the VIEW protocol in year one, defined as eyes having received 7 or 8 injections from baseline.ResultsThe mean number of intravitreal injections (IVI)s during year 2 was 3.7 in 1180 eyes (1083 patients). The mean baseline VA of the whole cohort was 56.3 ETDRS letters, improving to 61.3 at 1 year (+5) and 59.1 (+2.8) at the end of year 2. The mean VA letter score at the end of year 2, stratified by number of IVIs into three groups was as follows: group A, 57.3 (gain of +1.7) (44% of eyes (</=3 IVIs)); group B, 59.8 (+3.8) (34% of eyes (4-5 IVIs)); group C, 61.7 (+3.7) (22% of eyes (>/=6 IVIs)). Even though there were VA gains in the three groups over the 2-years, there was a drop in VA in year one to two. Eyes that received >/=6 IVIs (group C) had a smaller reduction of VA during year 2 than those which received </=3 IVIs (group A) (P=0.0014).ConclusionsProviding a higher number of injections after a Q8 regime in year 1 results in higher VA gains in year 2 of treatment.
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The requirement for lifelong injections imposes a substantial burden on patients and caregivers, and many patients fail to maintain initial therapeutic benefits owing to noncompliance with the burdensome treatment regimen.
“However, the requirement for lifelong injections imposes a substantial burden on patients and caregivers, and many patients fail to maintain initial therapeutic benefits owing to noncompliance with the burdensome treatment regimen. 3 , 7 , 8 , 10 , 13 – 20”
From Design and Characterization of a Novel Intravitreal Dual-Transgene Genetic Medicine for Neovascular Retinopathies (2024) · cites this paper as [16]
The Discussion (page unavailable) says that more injections in year two were associated with better preservation of first-year visual-acuity gains. It suggests that difficulty attending visits or reluctance to receive multiple injections might explain some lower injection frequencies, but says the reasons are unknown. It does not establish noncompliance as the cause of lost benefit or address lifelong treatment and caregiver burden. (LLM, conf=0.86)
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- Authors
- Almuhtaseb, H., Johnston, R. L., Talks, J. S., & Lotery, A. J.
- Affiliations
- University Hospital Southampton NHS Foundation Trust (GB)
- Gloucestershire Hospitals NHS Foundation Trust (GB)
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Lotery, A J
- Venue
- Eye
- Published
- 2017-06-16
- Volume
- 31
- Issue
- 11
- Pages
- 1582-1588
- ISSN
- 0078-5334 (ISSN-L)
- 0950-222X
- 1476-5454
- PMC
- PMC5684449
- OpenAlex
- W2626334457
- Cited by
- 33
- References
- 10
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 2 · 2022: 8 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 4 · 2017: 1
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Eye (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0515-10020)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- neovascular age-related macular degeneration, aflibercept, visual acuity outcomes, intravitreal injection, treatment-naive patients, long-term treatment
- MeSH terms
- Aged, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Fluorescein Angiography, Follow-Up Studies, Fundus Oculi, United Kingdom, Humans, Macula Lutea, Male, Middle Aged, Recombinant Fusion Proteins, Retrospective Studies, Time Factors, Visual Acuity, Treatment Outcome, Receptors, Vascular Endothelial Growth Factor, Tomography, Optical Coherence, Wet Macular Degeneration, Electronic Health Records, Intravitreal Injections
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