February 22, 2020

“How long will my anti-VEGF drug therapy be effective?”

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“How long will my anti-VEGF drug therapy be effective?”

This is becoming a common question among people who have been treated for years with anti-VEGF drug therapy. These eye injections are the gold standard for treatment of wet age-related macular degeneration (wAMD), having been first used clinically in 2004.

The news is good. A recent retrospective review in the U.K. has found that almost 50% of eyes with wAMD continued to be stable or improved after 8 years of treatment with Lucentis (ranibizumab). This compares favorably with other similar studies in the U.S., Belgium, and Australia. 86 patients, average age 72, were injected a mean total of 31.6 times during the 8 years, which included 3 initial loading doses and treatment as needed thereafter. Half of the patients needed yearly injections, and a quarter of the patients were able to stop injections for a year or more due to achieving stability.

As expected, due to the underlying effects of the disease, about 34% of the patients lost up to 15 letters of acuity, but nearly 50% of eyes had maintained or even improved vision. In other words, the effectiveness of anti-VEGF treatment may not have a time limit. And if a patient does become resistant to a particular drug, practitioners have had success, other than in rare cases) with switching to another of the four leading products: Lucentis, Eylea, Beovu, and off-label Avastin.  

The research team concluded that the results of this study could serve as “useful, relevant information” in counseling wAMD patients about their expectations. And patients can take comfort in knowing that they are protected well into the future.

SOURCE:

Real-World Visual And Clinical Outcomes For Patients With Neovascular Age-Related Macular Degeneration Treated With Intravitreal Ranibizumab: An 8-Year Observational Cohort (AMD8) by Horner F. et al . (Clin Ophthalmol 2019;13:2461-2467.)

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