增加给药间隔的大剂量阿非利西普作为DMO和nAMD的新护理标准

S. Adrean
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引用次数: 0

摘要

血管内皮生长因子抑制剂的引入对新生血管性年龄相关性黄斑变性(nAMD)和糖尿病性黄斑水肿(DMO)患者有显著改善。具有里程碑意义的试验-如用于nAMD和RIDE/RISE的ANCHOR、MARINA和VIEW,用于DMO的VIVID和VISTA -显示出积极的结果,包括早期治疗糖尿病视网膜病变研究的临床有意义的获益,抗血管内皮生长因子药物现在是nAMD和DMO的标准治疗。最近的研究,包括那些研究大剂量阿非利西普在nAMD和DMO中的研究,通过研究增加治疗间隔来减少患者和医生的治疗负担,重点关注反应的持久性。PULSAR (nAMD)和PHOTON (DMO)试验包括高剂量(8mg) aflibercept,在12周或16周的给药间隔中,与标准剂量2mg相比,显示出非较差的视力改善,≥83%的患者在整个48周的研究中维持延长的给药间隔。这无疑是一项令人兴奋的进展,延长治疗的持久性将如何影响nAMD和DMO患者的管理模式,这将是一件有趣的事情。
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High-dose Aflibercept with Increased Dosing Intervals as a New Standard of Care for DMO and nAMD
The introduction of vascular endothelial growth factor inhibitors has led to significant improvements for patients with neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO). Landmark trials – such as ANCHOR, MARINA and VIEW for nAMD and RIDE/RISE, VIVID and VISTA for DMO – showed positive results, including clinically meaningful gains in Early Treatment Diabetic Retinopathy Study letters, with anti-vascular endothelial growth factor agents now the standard of care for nAMD and DMO. More recent studies, including those investigating high-dose aflibercept in nAMD and DMO, have focused on durability of response by studying increased treatment intervals to reduce the treatment burden on patients and physicians alike. The PULSAR (nAMD) and PHOTON (DMO) trials included high-dose (8 mg) aflibercept at either 12-week or 16-week dosing intervals and showed non-inferior visual gains compared with the standard dose of 2 mg, with ≥83% of patients maintaining their extended dosing interval throughout the 48-week studies. This is certainly an exciting development, and it will be interesting to see how extended treatment durability will impact management paradigms for patients with nAMD and DMO.
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