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Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel

Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel
Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel
This paper provides expert recommendations on administration of aflibercept in wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a roundtable discussion held in London, UK in November 2014. The goals of treatment after Y1 are to maintain visual and anatomical gains whilst minimising treatment burden and using resources effectively. The treatment decision should be made at the seventh injection visit (assuming the label has been followed) in Y1, and three approaches are proposed: (a) eyes with active disease on imaging/examination but with stable visual acuity (VA) at the end of Y1 should continue with fixed 8-weekly dosing; (b) eyes with inactive disease on imaging/examination and stable VA should be managed using a 'treat and extend' (T&E) regimen. T&E involves treating and then extending the interval until the next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the disease remains inactive. If there is new evidence of disease activity, treatment is administered and the interval to the next treatment shortened; and (c) if there has been no disease activity for ?3 consecutive visits, a trial of monitoring without treatment may be appropriate, initiated at the end of Y1 or at any time during Y2. Where possible, VA testing, OCT imaging and injection should be performed at the same visit. The second eye should be monitored to detect fellow eye involvement. In bilateral disease, the re-treatment interval should be driven by the better-seeing eye or, if the VA is similar, the eye with the more active disease.
0950-222X
S1-S11
McKibbin, M.
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Devonport, H.
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Gale, R.
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Gavin, M.
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Lotery, A.
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Mahmood, S.
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Patel, P.J.
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Ross, A.
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Sivaprasad, S.
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Talks, J.
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Walters, G.
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McKibbin, M.
65e194c2-62e4-4a79-b442-ef92de81e625
Devonport, H.
deb0837f-1930-45a6-8b78-cff98a4503fb
Gale, R.
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Gavin, M.
79aa66f4-a19c-4279-80d4-949285f045bf
Lotery, A.
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Mahmood, S.
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Patel, P.J.
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Ross, A.
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Sivaprasad, S.
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Talks, J.
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Walters, G.
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McKibbin, M., Devonport, H., Gale, R., Gavin, M., Lotery, A., Mahmood, S., Patel, P.J., Ross, A., Sivaprasad, S., Talks, J. and Walters, G. (2015) Aflibercept in wet AMD beyond the first year of treatment: recommendations by an expert roundtable panel. Eye, 29, supplement 1, S1-S11. (doi:10.1038/eye.2015.77). (PMID:26156564)

Record type: Article

Abstract

This paper provides expert recommendations on administration of aflibercept in wet age-related macular degeneration (AMD) after Year 1 (Y1), based on a roundtable discussion held in London, UK in November 2014. The goals of treatment after Y1 are to maintain visual and anatomical gains whilst minimising treatment burden and using resources effectively. The treatment decision should be made at the seventh injection visit (assuming the label has been followed) in Y1, and three approaches are proposed: (a) eyes with active disease on imaging/examination but with stable visual acuity (VA) at the end of Y1 should continue with fixed 8-weekly dosing; (b) eyes with inactive disease on imaging/examination and stable VA should be managed using a 'treat and extend' (T&E) regimen. T&E involves treating and then extending the interval until the next treatment, by 2-week intervals, to a maximum of 12 weeks, provided the disease remains inactive. If there is new evidence of disease activity, treatment is administered and the interval to the next treatment shortened; and (c) if there has been no disease activity for ?3 consecutive visits, a trial of monitoring without treatment may be appropriate, initiated at the end of Y1 or at any time during Y2. Where possible, VA testing, OCT imaging and injection should be performed at the same visit. The second eye should be monitored to detect fellow eye involvement. In bilateral disease, the re-treatment interval should be driven by the better-seeing eye or, if the VA is similar, the eye with the more active disease.

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Published date: 29 July 2015
Organisations: Faculty of Medicine

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Local EPrints ID: 390412
URI: http://eprints.soton.ac.uk/id/eprint/390412
ISSN: 0950-222X
PURE UUID: 3c0052fd-6283-4d73-8bda-decddaa84054
ORCID for A. Lotery: ORCID iD orcid.org/0000-0001-5541-4305

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Date deposited: 01 Apr 2016 11:04
Last modified: 10 Sep 2019 00:46

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Contributors

Author: M. McKibbin
Author: H. Devonport
Author: R. Gale
Author: M. Gavin
Author: A. Lotery ORCID iD
Author: S. Mahmood
Author: P.J. Patel
Author: A. Ross
Author: S. Sivaprasad
Author: J. Talks
Author: G. Walters

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