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Aflibercept for Intravitreal Injection

In Neovascular Age-Related Macular Degeneration

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Abstract

Aflibercept is a recombinant human fusion protein that acts as a soluble decoy receptor for vascular endothelial growth factor (VEGF) family members VEGF-A, VEGF-B and placental growth factor, thereby preventing these ligands from binding to, and activating, their cognate receptors. The efficacy of intravitreal aflibercept in the treatment of wet (neovascular) age-related macular degeneration has been compared with that of intravitreal ranibizumab, the current gold standard for this indication, in two pivotal phase III studies of virtually identical design (VIEW 1 and 2). In both trials, the recommended regimen of aflibercept [2 mg every second month (after three initial monthly doses)] was shown to be noninferior to the recommended regimen of ranibizumab (0.5 mg every month) in terms of the primary endpoint of the proportion of patients who maintained their vision after 1 year of treatment; similar results were seen when monthly dosing with aflibercept (0.5 or 2 mg) was compared with ranibizumab. Over a period of 96 weeks in the VIEW studies, patients receiving the recommended regimen of aflibercept during the first year followed by modified quarterly treatment during the second year had a similar visual acuity gain to those receiving the recommended regimen of ranibizumab during first year followed by modified quarterly treatment during the second year, but on average required five fewer injections. Aflibercept was generally well tolerated in the VIEW studies; the ocular and non-ocular adverse event profile of the drug was similar to that of ranibizumab.

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Disclosure

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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  1. Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754, Auckland, New Zealand

    James E. Frampton

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Correspondence to James E. Frampton.

Additional information

The manuscript was reviewed by: D.A. Boyer, University of Southern California Keck School of Medicine, Los Angeles, CA, USA; M. W. Stewart, Department of Ophthalmology, Mayo Clinic Florida, Jacksonville, FL, USA.

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Frampton, J.E. Aflibercept for Intravitreal Injection. Drugs Aging 29, 839–846 (2012). https://doi.org/10.1007/s40266-012-0015-2

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