Evidence map›Paper›PMID 38183525›Full record

Trial reportAdvances in therapy2024

Intravitreal Aflibercept for Neovascular Age-Related Macular Degeneration Beyond One Year of Treatment: AZURE, a Randomized Trial of Treat-and-Extend vs. Fixed Dosing.

Laurent Kodjikian, Lluís Arias Barquet, András Papp, Peter J Kertes, Edoardo Midena, Jan Ernest, Rufino Silva, Thomas Schmelter, Tobias Niesen, Sergio Leal

Registry-linked trialOpen access · hybridAbstract readClinical Trial, Phase IIIEquivalence TrialRandomized Controlled Trial
In one paragraph

Trial report in Advances in therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02540954 (An Open-label, Randomized, Active-controlled, Parallel-group, Phase-3b Study of the Efficacy, Safety, and Tolerability of 2 mg Aflibercept Administered by Intravitreal Injections Using Two Different Treatment Regimens to Subjects With Neovascular Age-related Macular Degeneration), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 20% 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.

NCT02540954 phase3completednot on this map

An Open-label, Randomized, Active-controlled, Parallel-group, Phase-3b Study of the Efficacy, Safety, and Tolerability of 2 mg Aflibercept Administered by Intravitreal Injections Using Two Different Treatment Regimens to Subjects With Neovascular Age-related Macular Degeneration (nAMD).

TypeinterventionalSponsorBayerRan2015 to 2020Enrolled336ConditionsMacular DegenerationArmsAflibercept (Eylea, VEGF Trap-Eye, BAY86-5321)
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
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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

10 authors at 8 institutions in 9 countries.

Laurent KodjikianDepartment of Ophthalmology, Croix-Rousse Teaching Hospital, Hospices Civils de Lyon, Lyon, France. laurent.kodjikian@chu-lyon.fr.ORCID 0000-0002-3908-6716
Lluís Arias BarquetDepartment of Ophthalmology, Hospital Universitario de Bellvitge, Barcelona, Spain.
András PappDepartment of Ophthalmology, Semmelweis University, Budapest, Hungary.
Peter J KertesThe John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.ORCID 0000-0002-0348-5096
Edoardo MidenaDepartment of Ophthalmology, University Hospital, Padua, Italy.
Jan ErnestAxon Clinical Research Center, Prague, Czech Republic.
Rufino SilvaCoimbra Institute for Clinical and Biomedical Research Faculty of Medicine (iCBR-FMUC), University of Coimbra, Coimbra, Portugal.ORCID 0000-0001-8676-0833
Thomas SchmelterBayer AG, Berlin, Germany.ORCID 0000-0003-1358-3172
Tobias NiesenBayer AG, Berlin, Germany.
Sergio LealBayer Consumer Care AG, Basel, Switzerland.
Bayer (Germany) · DEBayer (Switzerland) · CHBellvitge University Hospital · ESHospitais da Universidade de Coimbra · PTSemmelweis University · HUSunnybrook Health Science Centre · CAUniversité Claude Bernard Lyon 1 · FRUniversity of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAZURE was a 76-week, randomized, open-label, parallel-group, phase IIIb noninferiority study comparing the efficacy and safety of intravitreal aflibercept (IVT-AFL) in a treat-and-extend (T&E) regimen with fixed dosing in patients with neovascular age-related macular degeneration (nAMD) previously receiving IVT-AFL for ≥ 1 year.

methodsPatients were aged ≥ 51 years and had completed ≥ 1 year of IVT-AFL treatment prior to enrollment (IVT-AFL once per month [- 1 or + 2 weeks] for 3 months followed by IVT-AFL every 2 months [6-12 weeks]). Patients were randomly assigned (1:1) to receive IVT-AFL 2 mg in either a T&E (minimum treatment interval of 8 weeks with no upper limit, adjusted according to functional and anatomic outcomes, as assessed by the investigator; n = 168), or a fixed dosing regimen (treatment every 8 weeks [± 3 days]; n = 168). The primary endpoint was best-corrected visual acuity (BCVA) change from baseline to week (W) 52. The key secondary endpoint was the proportion of patients maintaining vision (< 15-letter loss) at W52.

resultsThe full analysis set comprised 332 patients (T&E: n = 165; fixed dosing: n = 167). Mean BCVA change (baseline to W52) was - 0.3 ± 7.5 vs. - 0.5 ± 8.4 letters (T&E vs. fixed dosing; least-squares mean difference [95% CI]: 0.22 [- 1.51 to 1.96] letters; P < 0.0001 for noninferiority test [5-letter margin]). From baseline to W52, 95.2% (T&E) and 94.0% (fixed dosing) of patients maintained vision. Mean central subfield thickness change from baseline to W52 was - 24 ± 55 (T&E) and - 33 ± 47 (fixed dosing) µm. Last treatment interval to W76 was ≥ 12 weeks for 37.0% of T&E patients. No new safety signals were identified.

conclusionIVT-AFL T&E can achieve similar functional and anatomic outcomes to fixed dosing every 8 weeks over 52 weeks in patients with nAMD who have completed ≥ 1 year of treatment, while reducing treatment burden.

trial registrationClinicalTrials.gov Identifier: NCT02540954.

Indexed as

Macular DegenerationReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsAgedHumansIntravitreal InjectionsMiddle AgedTreatment OutcomeVisual AcuityafliberceptReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsAnatomic outcomesAnti-vascular endothelial growth factorFixed dosingFunctional outcomesIntravitreal afliberceptNeovascular age-related macular degenerationTreat-and-extendTreatment burdenTreatment interval

Identifiers

PMID38183525
PMCPMC10879225
OpenAlexW4390637832

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

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.