Evidence map›Paper›PMID 30806775›Full record

ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2019

Durability of every-8-week aflibercept maintenance therapy in treatment-experienced neovascular age-related macular degeneration.

Kunny C Dans, Sarah R Freeman, Tiezhu Lin, Amit Meshi, Sergio Olivas, Lingyun Cheng, Manuel J Amador-Patarroyo, William R Freeman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 4 countries.

Kunny C DansDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
Sarah R FreemanDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
Tiezhu LinDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
Amit MeshiDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
Sergio OlivasDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
Lingyun ChengDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
Manuel J Amador-PatarroyoDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA.
William R FreemanDepartment of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA. wrfreeman@ucsd.edu.
University of California, San Diego · USInstituto Barraquer de América · COTel Aviv University · IL

Funding

Vision BiostatisticsP30EY022589 · NEI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Derek Stuart Welsbie · 2012 to 2026
$10.3M
Porous Silicon Particles for Sustained Intravitreal Drug DeliveryR01EY020617 · NEI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI CHENG, LINGYUN · 2011 to 2015
$2.6M
Crystalline Antiproliferative Drugs for Intraocular DiseasesR01EY018589 · NEI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FREEMAN, WILLIAM R. · 2008 to 2011
$2.0M
NEI NIH HHS P30 EY022589NEI NIH HHS R01 EY018589NEI NIH HHS R01 EY020617University of California, San Diego (US) Vision Research Center Core Grant P30EY022589
6 · The paper itself

Abstract

purposeTo determine the proportion of treatment-experienced eyes with exudative age-related macular degeneration successfully treated with every-4-week aflibercept that can be kept dry on fixed every-8-week aflibercept injections (maintenance).

methodsIn this retrospective chart review, we evaluated our cohort of patients treated with a treatment paradigm for CNV in AMD. Initially, patients were treated with bevacizumab or ranibizumab and switched to every-4-week aflibercept when therapeutic responses were not durable or were suboptimal. Maintenance every-8-week therapy was initiated when the retina was completely dry on every-4-week aflibercept therapy. The primary outcome measure was recurrence of exudation on optical coherence tomography (OCT) during maintenance.

resultsThirty-six eyes of 31 consecutive patients with median age of 79 years (range, 65-89) were included. Maintenance was started after a median of 34 (range, 8-88) injections. Recurrence was observed in 20 eyes (55%). Of these, 11 eyes (31%) reactivated at 8 weeks. Median time to failure of maintenance schedule was 40 weeks by Kaplan-Meier analysis. Baseline demographic and anatomic characteristics were not associated with failure of maintenance schedule.

conclusionIn treatment-experienced eyes that respond completely to every-4-week aflibercept, maintenance therapy with every-8-week injections can only temporarily maintain anatomic success with the majority of eyes developing recurring activity. This regimen fails early in one third of eyes and has a median effective duration of 40 weeks. Aflibercept appears to be inadequate to maintain control of exudation in most eyes in at least half of eyes undergoing long-term therapy.

Indexed as

AgedAged, 80 and overAngiogenesis InhibitorsFemaleFluorescein AngiographyFollow-Up StudiesHumansIntravitreal InjectionsMaintenance ChemotherapyMaleReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsRetinaRetrospective StudiesTime FactorsTomography, Optical CoherenceafliberceptAngiogenesis InhibitorsReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor AVEGFA protein, humanAfliberceptAnti-VEGFFixedMaintenanceNeovascular AMDOptical coherence tomography

Identifiers

PMID30806775
PMCPMC6441364
OpenAlexW2916671929

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.