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Outcomes after switching eyes that were stable on aflibercept to ranibizumab versus continuing aflibercept in neovascular age-related macular degeneration

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To describe outcomes of neovascular age-related macular degeneration (nAMD) eyes that were stable on aflibercept but switched to ranibizumab compared to eyes maintained on aflibercept over the same period.

Methods

In this retrospective cohort study, eyes switched from aflibercept to ranibizumab due to intraocular inflammation (IOI) concerns with aflibercept were identified. Data was gathered from 3 visits pre-switch, switch visit (Sw), and 3 visits post-switch (P1, P2, P3). Similar data was gathered on eyes eligible to switch but continued on aflibercept with the middle visit considered the “presumed switch.” Outcome measures included visual acuity (VA) and central foveal thickness (CFT).

Results

A total of 142 eyes were analyzed with 71 in each of the switch and aflibercept groups. In the switch group, mean CFT increased from 165.7 µm at Sw to 184.7 µm at P1 (p = 0.009), 180.9 µm at P2 (p = 0.007), and 183.3 µm at P3 (p = 0.004). VA changed from logMAR 0.43 (20/54) at Sw to 0.49 (20/61) at P1 (p = 0.02), 0.54 (20/69) at P2 (p = 0.008), and 0.53 (20/68) at P3 (p = 0.04). In the aflibercept group, no significant change in CFT was found over the same period. VA changed from logMAR 0.56 (20/72) at the “presumed switch” to 0.58 (20/76) at P1 (p = 0.085), 0.62 (20/83) at P2 (p = 0.001), and 0.59 (20/77) at P3 (p = 0.14).

Conclusions

nAMD eyes that were stable or improving on aflibercept but were switched to ranibizumab worsened, while those in a comparable group maintained on aflibercept remained fairly stable, suggesting a potential efficacy difference between the two drugs.

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Authors and Affiliations

  1. Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Suite 1020, 840 Walnut Street, Philadelphia, PA, 19107, USA

    Mirataollah Salabati, Anthony Obeid, Raziyeh Mahmoudzadeh, Omesh Gupta, Allen Chiang, Marc Spirn, Michael A. Klufas & Jason Hsu

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  1. Mirataollah Salabati
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  2. Anthony Obeid
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  3. Raziyeh Mahmoudzadeh
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  4. Omesh Gupta
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  5. Allen Chiang
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Consortia

the Wills Switch Study Group

Corresponding author

Correspondence to Jason Hsu.

Ethics declarations

Ethics approval

This study was approved by Wills Eye Hospital institutional review board and adhered to the tenets of the Declaration of Helsinki.

Informed consent

Not applicable.

Conflict of interest

M.S, A.O, R.M, and Dr. Spirn have no financial disclosures. Dr. Hsu is a consultant for IVERIC Bio (New York, NY), Gyroscope Therapeutics (London, UK), and OccuRx Pty Ltd (Melbourne, Australia). He has received grants from Roche/Genentech (San Francisco, CA), Aldeyra Therapeutics (Lexington, MA), and IVERIC Bio (New York, NY). Dr. Gupta is a consultant for Alcon. Dr. Chiang reported receiving grants from Genentech and Regeneron and is a consultant for Genentech. Dr. Klufas is a consultant for Allergan (Dublin, Ireland), Speaker and Consultant for Roche/Genentech (San Francisco, CA), and Speaker for Regeneron (Tarrytown, NY).

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Appendix

Appendix

Wills Switch Study Group

Phoebe L. Mellen, MD, Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA

Turner D. Wibbelsman, BS, Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA

Michelle A. Konkoly, BS, Thomas Jefferson University, Philadelphia, PA, USA

Michael R. Velez BS, Thomas Jefferson University, Philadelphia, PA, USA

Daniel B. Calem BS, Thomas Jefferson University, Philadelphia, PA, USA

Daniel Su MD, Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA

Philip P. Storey, MD, Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA

Carl D. Regillo, MD, Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA

Allen C. Ho, MD, Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Philadelphia, PA, USA

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Salabati, M., Obeid, A., Mahmoudzadeh, R. et al. Outcomes after switching eyes that were stable on aflibercept to ranibizumab versus continuing aflibercept in neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 260, 2509–2516 (2022). https://doi.org/10.1007/s00417-022-05601-0

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  • DOI: https://doi.org/10.1007/s00417-022-05601-0

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