Two different treat-and-extend protocols with aflibercept in wet AMD suggest fewer injections

Researchers at the Helsinki Retina Research Group at the University of Helsinki, Finland report that while two treatment protocols – either moderate or rapid extensions – do not change the visual acuity or central subfield macular thickness (CSMT), the mean number of injections was lower and the treatment interval longer in the treat-and-extend group with rapid extensions.  From the research study the report concluded that at the 1-year period, the biological responses were comparable between the moderate and rapid extensions protocols.  The results indicated that fewer aflibercept injections in the rapid extension protocol may be suitable, compared to the moderate protocol.

 

Treat-and-extend protocol strategies for several anti-VEGF agents was introduced by many research groups with the objective to reduce the frequency of visits and injections without sacrificing the efficacy of the treatment. However, according to the Finnish study, only few trials have reported results from aflibercept treat-and-extend protocols in wet AMD and the aim of the study uses two different variants of the protocol in treatment- naïve patients for wet AMD. The current study used a prospective randomized clinical trial to recruit 52 patients with treatment-naïve wet age-related macular degeneration (AMD). Patients received three monthly aflibercept injections and were then randomized 1:1 to two different dosing protocols. In treat-and-extend protocol with moderate extensions (“M”), after the loading phase the treatment interval was extended 1 week at a time up to 12 weeks and then by 2 weeks up to 16 weeks. While in comparison, in treat-and-extend protocol with rapid extensions (“R”), the interval was first extended to 8 weeks and then by 2 weeks at a time up to 16 weeks.  The main outcome measure of the study was the number of given aflibercept injections and the result then was compared between protocol M or protocol R.

 

In the results, fifty (96%) patients completed the 1-year follow-up and this reported that at 1 year, the central subfield macular thickness (CSMT) was reduced by 194.3 ±153.6 µm in “M” protocol, compared with 194.2 ±176.6 µm with the “R” protocol (p=0.997) i.e., both of the protocols were essentially identical. Eyes with the M protocol gained 10.3 ±11.5 letters from baseline and eyes with the R protocol 11.4 ±10.6 letters (p=0.434).  In addition, dry macula reported that 72% of eyes were with the M protocol, compared to 68% with the R protocol (p=0.758). At 1 year, the treatment interval was 8.5 ±2.2 weeks in the M protocol and 10.3 ±2.8 weeks in the R protocol (p=0.017), and the total number of injections 8.64 ±1.58 and 6.96 ±0.79, respectively (p<0.001). In the R extension protocol, 48% of eyes reached a 12-week treatment interval or beyond at 1 year.

331 thoughts on “Two different treat-and-extend protocols with aflibercept in wet AMD suggest fewer injections”

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  124. I needed to thank you for this excellent read!! I certainly enjoyed every bit of it. I’ve got you book marked to check out new stuff you post…

  125. I was very happy to discover this site. I wanted to thank you for your time just for this wonderful read!! I definitely appreciated every little bit of it and I have you bookmarked to look at new things on your blog.

  126. Can I simply just say what a relief to find someone who actually understands what they’re discussing on the net. You actually know how to bring an issue to light and make it important. More people should look at this and understand this side of your story. I was surprised you are not more popular since you certainly have the gift.

  127. Do you mind if I quote a couple of your posts as long as I provide credit and sources back to your website? My blog is in the exact same area of interest as yours and my users would definitely benefit from a lot of the information you present here. Please let me know if this okay with you. Many thanks!

  128. Great blog! Is your theme custom made or did you download it from somewhere? A design like yours with a few simple tweeks would really make my blog shine. Please let me know where you got your theme. Bless you

  129. Hello, I think your site may be having web browser compatibility issues. When I take a look at your website in Safari, it looks fine however, when opening in Internet Explorer, it has some overlapping issues. I merely wanted to give you a quick heads up! Besides that, excellent website!

  130. You made some decent points there. I looked on the internet for more info about the issue and found most individuals will go along with your views on this website.

  131. When I originally left a comment I seem to have clicked on the -Notify me when new comments are added- checkbox and from now on whenever a comment is added I receive four emails with the exact same comment. Perhaps there is a means you can remove me from that service? Cheers!

  132. I don’t know whether it’s just me or if everyone else experiencing problems with your blog. It appears as if some of the text within your posts are running off the screen. Can somebody else please provide feedback and let me know if this is happening to them too? This could be a problem with my internet browser because I’ve had this happen before. Thank you

  133. Write more, thats all I have to say. Literally, it seems as though you relied on the video to make your point. You definitely know what youre talking about, why waste your intelligence on just posting videos to your weblog when you could be giving us something enlightening to read?

  134. Hello! I understand this is kind of off-topic but I needed to ask. Does running a well-established website such as yours require a massive amount work? I’m completely new to blogging however I do write in my diary every day. I’d like to start a blog so I can easily share my personal experience and feelings online. Please let me know if you have any recommendations or tips for new aspiring blog owners. Thankyou!

  135. The following time I check out a blog site, I really hope that it does not disappoint me as long as this. I indicate, I understand it was my choice to check out, but I in fact believed youd have something fascinating to state. All I listen to is a bunch of grumbling concerning something that you could fix if you werent as well active seeking interest.

  136. An excellent share, I simply provided this onto a coworker that was doing a little evaluation on this. And also he actually got me breakfast since I discovered it for him. smile. So let me rephrase that: Thnx for the reward! Yet yeah Thnkx for spending the time to review this, I feel highly about it and also love finding out more on this subject. Ideally, as you become experience, would you mind upgrading your blog with even more details? It is very handy for me. Big thumb up for this blog post!

  137. Aw, this was an incredibly nice post. Taking the time and actual effort to create a good article… but what can I say… I hesitate a lot and never manage to get anything done.

  138. You’re so cool! I do not suppose I’ve truly read anything like this before. So good to discover another person with unique thoughts on this subject. Really.. thank you for starting this up. This site is one thing that is needed on the web, someone with some originality!

  139. I have to thank you for the efforts you have put in penning this blog. I am hoping to check out the same high-grade blog posts by you in the future as well. In fact, your creative writing abilities has inspired me to get my own website now 😉

  140. Can I simply just say what a comfort to uncover an individual who really understands what they’re talking about on the net. You actually understand how to bring a problem to light and make it important. More people have to read this and understand this side of your story. I can’t believe you aren’t more popular because you most certainly have the gift.

  141. I’d like to thank you for the efforts you have put in penning this website. I am hoping to check out the same high-grade content from you in the future as well. In fact, your creative writing abilities has inspired me to get my own blog now 😉

  142. An outstanding share! I’ve just forwarded this onto a coworker who was doing a little homework on this. And he in fact bought me breakfast because I discovered it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanx for spending some time to discuss this matter here on your site.

  143. You have made some good points there. I checked on the net for additional information about the issue and found most people will go along with your views on this web site.

  144. I absolutely love your website.. Pleasant colors & theme. Did you make this site yourself? Please reply back as I’m attempting to create my own blog and would love to learn where you got this from or just what the theme is called. Cheers!

  145. Hi there! I could have sworn I’ve visited this site before but after browsing through some of the articles I realized it’s new to me. Nonetheless, I’m definitely happy I stumbled upon it and I’ll be bookmarking it and checking back regularly!

  146. Hi there! This article couldn’t be written any better! Looking at this post reminds me of my previous roommate! He continually kept talking about this. I am going to send this article to him. Pretty sure he’ll have a good read. Thank you for sharing!

  147. You’re so interesting! I don’t think I’ve read something like this before. So nice to discover another person with original thoughts on this issue. Seriously.. thanks for starting this up. This website is one thing that is needed on the web, someone with some originality!

  148. Hello there, I believe your site may be having internet browser compatibility issues. Whenever I look at your site in Safari, it looks fine however, when opening in IE, it’s got some overlapping issues. I merely wanted to provide you with a quick heads up! Aside from that, wonderful site!

  149. Spot on with this write-up, I truly feel this website needs far more attention. I’ll probably be returning to read more, thanks for the info!

  150. Spot on with this write-up, I seriously believe this website needs a lot more attention. I’ll probably be returning to see more, thanks for the info!

  151. A fascinating discussion is definitely worth comment. I do believe that you should publish more on this subject, it might not be a taboo subject but typically people do not talk about such issues. To the next! Cheers!!

  152. Oh my goodness! an amazing short article man. Thank you Nonetheless I am experiencing issue with ur rss. Don?t know why Unable to subscribe to it. Is there any individual obtaining identical rss trouble? Anyone who recognizes kindly respond. Thnkx

  153. Oh my goodness! Impressive article dude! Many thanks, However I am having issues with your RSS. I don’t understand the reason why I cannot join it. Is there anyone else having similar RSS problems? Anybody who knows the answer will you kindly respond? Thanx!!

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  155. Hi there! I could have sworn I’ve visited this blog before but after going through a few of the articles I realized it’s new to me. Nonetheless, I’m certainly pleased I came across it and I’ll be bookmarking it and checking back often!

  156. Aw, this was an extremely good post. Taking a few minutes and actual effort to produce a good article… but what can I say… I put things off a whole lot and never manage to get nearly anything done.

  157. I absolutely love your website.. Very nice colors & theme. Did you make this web site yourself? Please reply back as I’m hoping to create my own personal site and would like to find out where you got this from or what the theme is called. Appreciate it!

  158. This is the right site for anybody who wants to find out about this topic. You understand so much its almost hard to argue with you (not that I really would want to…HaHa). You definitely put a fresh spin on a topic that’s been discussed for ages. Excellent stuff, just wonderful!

  159. An outstanding share! I’ve just forwarded this onto a coworker
    who has been doing a little research on this. And he actually
    bought me dinner simply because I found it for him…
    lol. So allow me to reword this…. Thanks for the meal!!
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  160. You made some really good points there. I looked on the net for additional information about the issue and found most people will go along with your views on this site.

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