Universität zu Köln

Fauser, Sascha and Muether, Philipp S. (2016). Clinical correlation to differences in ranibizumab and aflibercept vascular endothelial growth factor suppression times. Br. J. Ophthalmol., 100 (11). S. 1494 - 1499. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-2079

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Abstract

Aim To determine clinical correlations to intraocular vascular endothelial growth factor A (VEGF-A) suppression times (VSTs) on the treatment of neovascular age-related macular degeneration (nAMD) with ranibizumab (Lucentis) or aflibercept (Eylea). Methods Seven of 89 treatment-naive nAMD eyes showed persistent choroidal neovascular membrane (CNV) activity throughout a spectral domain optical coherence tomography (SD-OCT)-driven pro re nata (PRN) regimen of intravitreal ranibizumab injections over 284months. The treatment was switched to PRN aflibercept injections and patients were followed for another 152months. A total of 160 aqueous humour specimens were collected before the intravitreal injections, and their VEGF-A concentrations were assayed by Luminex multiplex bead analysis (Luminex, Austin, Texas, USA). Intraocular VEGF-A concentrations were correlated to CNV activity shown by SD-OCT. Results The mean duration of suppression of VEGF-A concentrations in aqueous humour below the lower limit of quantification of our assay was 34 +/- 5 (26-69) days for ranibizumab and 67 +/- 14 (49-89) days for aflibercept (p<0.001). The percentual reduction of central retinal volume (CRV) 6weeks after injection was higher for aflibercept compared with ranibizumab (p=0.009). The time point of clinical re-activity occurred about 50% earlier than the respective VST for each ranibizumab and aflibercept. Conclusions The VST under aflibercept treatment exceeded that under ranibizumab treatment by a factor of 2. This difference correlated with differential clinical CRV reduction 6weeks after the respective injection. For both medications, clinical activity was found at a time point as early as 50% of the individual VST. Trial registration number NCT01213667, post-results

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fauser, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Muether, Philipp S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-256935
DOI:	10.1136/bjophthalmol-2015-308264
Journal or Publication Title:	Br. J. Ophthalmol.
Volume:	100
Number:	11
Page Range:	S. 1494 - 1499
Date:	2016
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-2079
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MACULAR DEGENERATION; TRAP-EYE; PHARMACOKINETICS; BEVACIZUMAB; EDEMA Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25693