The best treat-and-extend regimens for wet AMD

Boston-When treating patients with wet age-related macular degeneration (AMD), regular monthly therapy with anti-vascular endothelial growth factor (VEGF) therapies or patient monitoring results in optimal visual outcomes.

The more recently discussed treat-and-extend regimens offer a proactive approach to minimize the treatment burden with good visual outcomes. Difficult cases may benefit from combination therapy according to Jeffrey Heier, MD.

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Anti-VEGF agents have been the mainstay of AMD therapy for more than a decade. Over that time, clinicians have evaluated the strengths and weaknesses of the drugs and the dosing regimens in which the drugs are administered.

Dr. Heier, professor of ophthalmology, Tufts University School of Medicine and Harvard University Medical School, Boston, evaluated the currently used regimens to determine the ideal approaches for these patients.

Numerous studies have identified the efficacy and safety similarities achieved with ranibizumab (Lucentis, Genentech), bevacizumab (Avastin, Genentech), and aflibercept (Eylea, Regeneron Pharmaceuticals) in patients treated for wet AMD.

“The studies showed that regular anti-VEGF therapy is outstanding in maintaining visual acuity (VA) and very good for recovering vision,” he said. “However, deviations from regular therapy results in decreased VA, with longer-term follow-up of patients causing increased concerns.

“When we evaluate a regimen, the goal should be to maximize visual outcomes and minimize treatment burden,” he emphasized.

 

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