Cecilia S Lee1, Alisa J Kim2, Douglas Baughman2, Catherine Egan3,4, Clare Bailey5, Robert L Johnston6, Salim Natha7, Rehna Khan8, Christopher Brand9, Toks Akerele10, Martin McKibbin11, Louise Downey12, Saher Al-Husainy13, Aaron Y Lee1, Adnan Tufail3,4. 1. Department of Ophthalmology, University of Washington, Seattle, Washington. 2. University of Washington, Seattle, Washington. 3. The NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust. 4. UCL Institute of Ophthalmology, London, United Kingdom. 5. Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom. 6. Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom. 7. Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom. 8. Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom. 9. Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. 10. Hinchingbrooke Health Care NHS Trust, Huntingdon, United Kingdom. 11. Mid Yorkshire Hospitals NHS Trust. 12. Hull and East Yorkshire Hospitals NHS Trust, Hull, United Kingdom. 13. Heart of England NHS Foundation Trust, Solihull, United Kingdom.
Abstract
PURPOSE: To assess whether visual benefits exist in switching to aflibercept in patients who have been chronically treated with ranibizumab for neovascular age-related macular degeneration. METHODS: A multicenter, national, electronic medical record database study was performed. Patients undergoing six continuous monthly ranibizumab injections and then switched to continuous aflibercept were matched to those on continuous ranibizumab therapy. Matching was performed in a 2:1 ratio and based on visual acuity 6 months before and at the time of the switch, and the number of previous ranibizumab injections. RESULTS: Patients who were switched to aflibercept demonstrated transiently significant improvement in visual acuity that peaked at an increase of 0.9 Early Treatment Diabetic Retinopathy Study letters 3 months after the switch, whereas control patients continued on ranibizumab treatment showed a steady decline in visual acuity. Visual acuity differences between the groups were significant (P < 0.05) at 2, 3, and 5 months after the switch. Beginning at 4 months after the switch, the switch group showed a visual acuity decline similar to the control group. CONCLUSION: Transient, nonsustained improvement in visual acuity occurs when switching between anti-vascular endothelial growth factor agents, which may have implications in treating patients on chronic maintenance therapy on one anti-vascular endothelial growth factor medication.
PURPOSE: To assess whether visual benefits exist in switching to aflibercept in patients who have been chronically treated with ranibizumab for neovascular age-related macular degeneration. METHODS: A multicenter, national, electronic medical record database study was performed. Patients undergoing six continuous monthly ranibizumab injections and then switched to continuous aflibercept were matched to those on continuous ranibizumab therapy. Matching was performed in a 2:1 ratio and based on visual acuity 6 months before and at the time of the switch, and the number of previous ranibizumab injections. RESULTS:Patients who were switched to aflibercept demonstrated transiently significant improvement in visual acuity that peaked at an increase of 0.9 Early Treatment Diabetic Retinopathy Study letters 3 months after the switch, whereas control patients continued on ranibizumab treatment showed a steady decline in visual acuity. Visual acuity differences between the groups were significant (P < 0.05) at 2, 3, and 5 months after the switch. Beginning at 4 months after the switch, the switch group showed a visual acuity decline similar to the control group. CONCLUSION: Transient, nonsustained improvement in visual acuity occurs when switching between anti-vascular endothelial growth factor agents, which may have implications in treating patients on chronic maintenance therapy on one anti-vascular endothelial growth factor medication.
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