Aflibercept: A Review in Macular Oedema Secondary to Branch Retinal Vein Occlusion

Abstract

Aflibercept (Eylea^®) is a fully human, recombinant fusion protein available in various countries worldwide, including those of the EU, as well as the USA, for intravitreal use in the treatment of macular oedema secondary to branch retinal vein occlusion (BRVO) in adults. Aflibercept acts as a soluble decoy receptor, binding with high affinity to vascular endothelial growth factor (VEGF)-A and placental growth factor (PIGF), preventing these angiogenic factors from binding to and activating their cognate receptors. In a multinational, phase III study in this patient population, aflibercept was associated with a statistically significant and clinically relevant improvement in best-corrected visual acuity (BCVA) [as assessed by the proportion of eyes that gained ≥15 Early Treatment Diabetic Retinopathy Study letters from baseline] relative to macular laser photocoagulation during the first 24-week treatment period (aflibercept injections were administered every 4 weeks). Significant mean improvements from baseline in BCVA and central retinal thickness (CRT) relative to macular laser photocoagulation were also seen. These improvements were maintained relative to macular laser photocoagulation plus rescue aflibercept in a subsequent 24-week period (aflibercept injections were administered every 8 weeks). Aflibercept was generally well tolerated, locally and systemically, in this study, with a tolerability profile generally consistent with the known tolerability profile of the agent in other indications. Thus, intravitreal aflibercept extends the treatment options available for the management of macular oedema secondary to BRVO in adults.