Jean-François Korobelnik1, Frank G Holz2, Johann Roider3, Yuichiro Ogura4, Christian Simader5, Ursula Schmidt-Erfurth5, Katrin Lorenz6, Miki Honda7, Robert Vitti8, Alyson J Berliner8, Florian Hiemeyer9, Brigitte Stemper10, Oliver Zeitz11, Rupert Sandbrink12. 1. Service d'ophtalmologie, Hopital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; Université Bordeaux Segalen, Bordeaux, France; INSERM, L'Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France. Electronic address: jean-francois.korobelnik@chu-bordeaux.fr. 2. Department of Ophthalmology, University of Bonn, Bonn, Germany. 3. Department of Ophthalmology, University of Kiel, Kiel, Germany. 4. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Science, Nagoya, Japan. 5. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. 6. Department of Ophthalmology, University Medical Center, Johannes Gutenberg-Universität Mainz, Mainz, Germany. 7. Department of Ophthalmology, Juntendo University Urayasu Hospital, Chiba, Japan. 8. Regeneron Pharmaceuticals, Inc, Tarrytown, New York. 9. Bayer HealthCare AG, Berlin, Germany. 10. Bayer HealthCare AG, Berlin, Germany; Department of Neurology, University of Erlangen-Nürnberg, Germany. 11. Bayer HealthCare AG, Berlin, Germany; Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. 12. Bayer HealthCare AG, Berlin, Germany; Department of Neurology, Heinrich-Heine-Universität, Düsseldorf, Germany.
Abstract
PURPOSE: To evaluate the efficacy and safety of intravitreal aflibercept injections for treatment of macular edema secondary to central retinal vein occlusion (CRVO). DESIGN: A randomized, multicenter, double-masked phase 3 study. PARTICIPANTS: A total of 177 treatment-naive patients with macular edema secondary to CRVO were randomized in a 3:2 ratio. METHODS: Patients received either 2-mg intravitreal aflibercept or sham injections every 4 weeks for 20 weeks. From week 24 to 48, the aflibercept group received aflibercept as needed (pro re nata [PRN]), and the sham group continued receiving sham injections. MAIN OUTCOME MEASURES: The primary efficacy end point was the proportion of patients who gained 15 letters or more in best-corrected visual acuity (BCVA) at week 24. This study reports week 52 results including the proportion of patients who gained 15 letters or more in BCVA and the mean change from baseline BCVA and central retinal thickness. Efficacy end points at week 52 were all exploratory. RESULTS: At week 52, the mean percentage of patients gaining 15 letters or more was 60.2% in the aflibercept group and 32.4% in the sham group (P = 0.0004). Aflibercept patients, compared with sham patients, had a significantly higher mean improvement in BCVA (+16.9 letters vs. +3.8 letters, respectively) and reduction in central retinal thickness (-423.5 μm vs. -219.3 μm, respectively) at week 52 (P < 0.0001 for both). Aflibercept patients received a mean of 2.5 injections (standard deviation, 1.7 injections) during PRN dosing. The most common ocular adverse events in the aflibercept group were related to the injection procedure or the underlying disease, and included macular edema (33.7%), increased intraocular pressure (17.3%), and eye pain (14.4%). CONCLUSIONS: Treatment with intravitreal aflibercept provided significant functional and anatomic benefits after 52 weeks as compared with sham. The improvements achieved after 6 monthly doses at week 24 largely were maintained until week 52 with as-needed dosing. Intravitreal aflibercept generally was well tolerated.
RCT Entities:
PURPOSE: To evaluate the efficacy and safety of intravitreal aflibercept injections for treatment of macular edema secondary to central retinal vein occlusion (CRVO). DESIGN: A randomized, multicenter, double-masked phase 3 study. PARTICIPANTS: A total of 177 treatment-naive patients with macular edema secondary to CRVO were randomized in a 3:2 ratio. METHODS:Patients received either 2-mg intravitreal aflibercept or sham injections every 4 weeks for 20 weeks. From week 24 to 48, the aflibercept group received aflibercept as needed (pro re nata [PRN]), and the sham group continued receiving sham injections. MAIN OUTCOME MEASURES: The primary efficacy end point was the proportion of patients who gained 15 letters or more in best-corrected visual acuity (BCVA) at week 24. This study reports week 52 results including the proportion of patients who gained 15 letters or more in BCVA and the mean change from baseline BCVA and central retinal thickness. Efficacy end points at week 52 were all exploratory. RESULTS: At week 52, the mean percentage of patients gaining 15 letters or more was 60.2% in the aflibercept group and 32.4% in the sham group (P = 0.0004). Aflibercept patients, compared with sham patients, had a significantly higher mean improvement in BCVA (+16.9 letters vs. +3.8 letters, respectively) and reduction in central retinal thickness (-423.5 μm vs. -219.3 μm, respectively) at week 52 (P < 0.0001 for both). Aflibercept patients received a mean of 2.5 injections (standard deviation, 1.7 injections) during PRN dosing. The most common ocular adverse events in the aflibercept group were related to the injection procedure or the underlying disease, and included macular edema (33.7%), increased intraocular pressure (17.3%), and eye pain (14.4%). CONCLUSIONS: Treatment with intravitreal aflibercept provided significant functional and anatomic benefits after 52 weeks as compared with sham. The improvements achieved after 6 monthly doses at week 24 largely were maintained until week 52 with as-needed dosing. Intravitreal aflibercept generally was well tolerated.
Authors: T D Papakostas; L Lim; T van Zyl; J B Miller; B S Modjtahedi; C M Andreoli; D Wu; L H Young; I K Kim; D G Vavvas; D D Esmaili; D Husain; D Eliott; L A Kim Journal: Eye (Lond) Date: 2015-10-09 Impact factor: 3.775
Authors: Philip Hykin; A Toby Prevost; Sobha Sivaprasad; Joana C Vasconcelos; Caroline Murphy; Joanna Kelly; Jayashree Ramu; Abualbishr Alshreef; Laura Flight; Rebekah Pennington; Barry Hounsome; Ellen Lever; Andrew Metry; Edith Poku; Yit Yang; Simon P Harding; Andrew Lotery; Usha Chakravarthy; John Brazier Journal: Health Technol Assess Date: 2021-06 Impact factor: 4.014