Currently, no consensus exists on the optimal dosing strategy for anti-vascular endothelial growth factor (VEGF) agents in neovascular age-related macular degeneration (nAMD). A study assessed the comparative safety and efficacy of treat-and-extend (T&E) versus monthly and pro re nata (PRN). The results were presented at the American Academy of Ophthalmology (AAO) 2021 annual meeting.
In this meta-analysis, Prem Nichani, MD, and colleagues focused on analyzing randomized controlled trials. The primary endpoint was defined as improvement in best corrected visual acuity (BCVA). The secondary outcomes were defined as changes in central subfield thickness (CSFT), number of injections, and incidence of adverse events (AEs). In total, this analysis consisted of six trials, comprising 781 eyes receiving T&E, 663 with monthly, and 130 with PRN treatment.
The results of this study showed that the changes in BCVA, CSFT, and frequency of AEs were generally similar between comparators (P>0.05). The investigators observed that T&E eyes had markedly fewer injections than monthly eyes (P<0.001), but more than PRN eyes (P<0.001). Overall, the analysis demonstrated that the comparative efficacy and safety of T&E over other anti-VEGF dosing regimens are similar.
The researchers recommend “future assessment of patient satisfaction, treatment adherence and cost savings with T&E regimens.”
Source: Nichani P, et al. T&E Dosing of Intravitreal Anti-VEGF Agents in Neovascular and AMD: A Meta-Analysis of 1,697 Eyes. Poster 366. Published for AAO 2021; Nov. 12-15, 2021, New Orleans, LA.
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