AAO 2025: Diana Do reviews the real-world use of aflibercept 8 mg

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Diana Do, MD, a professor of ophthalmology and vice chair of Clinical Affairs at Stanford University's Byers Eye Institute, presented research on aflibercept 8 mg in treating neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME).

The study examined real-world outcomes across 2 key patient populations: treatment-naive eyes and prior-treated eyes. For treatment-naive patients, starting aflibercept 8 mg demonstrated significant clinical benefits. Patients achieved a mean injection interval of 12 weeks, with notable vision improvements: a 4-letter gain in wet AMD and a 5-letter improvement in DME, particularly for patients with initial vision worse than 20/50. In the prior-treated group, patients switching from 2 mg to 8 mg aflibercept experienced extended injection intervals by 2 additional weeks while maintaining vision stability.

The comprehensive analysis, encompassing over 10,000 eyes, revealed no new safety signals, aligning with previous clinical trial findings. The ALARA clinical trial provided further insights, evaluating flexible dosing of aflibercept 8 mg in eyes with prior anti-VEGF treatment. Patients were initially treated monthly up to week 24, then transitioned to a treat-and-extend regimen. Preliminary results were promising:

• Wet AMD eyes gained 2.3 letters of vision.
• Retinal thickness reduced by 32 microns.
• DME eyes gained nearly three letters of vision.
• Retinal thickness reduced by 50 microns.
• Maintained an excellent safety profile.

Key takeaways include the potential for extended treatment intervals, vision improvements, and reduced retinal thickness across both AMD and DME patient groups. The study's large-scale data provides clinicians with confidence in using aflibercept 8 mg in real-world clinical practice, offering a potentially more convenient and effective treatment option for patients with these sight-threatening conditions.