Evidence map›Paper›PMID 38710939›Full record

ArticleEye (London, England)2024

Impact of treat and extend criteria on proportions that can be extended after loading phase of 2 mg aflibercept therapy for neovascular age related macular degeneration: PRECISE Report 5.

Sridevi Thottarath, Sarega Gurudas, Swati Chandak, Praveen J Patel, Ajay Kotagiri, Ian Pearce, Martin McKibbin, Geeta Menon, Benjamin J L Burton, James Talks and 6 more

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In one paragraph

Article in Eye (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
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

16 authors.

Sridevi ThottarathNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Sarega GurudasNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Swati ChandakNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.ORCID http://orcid.org/0000-0001-8255-6253
Praveen J PatelNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.ORCID http://orcid.org/0000-0001-8682-4067
Ajay KotagiriSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Ian PearceThe Royal Liverpool and Broadgreen University Hospitals NHS Foundation Trust, Liverpool, UK.
Martin McKibbinLeeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID http://orcid.org/0000-0003-4388-243X
Geeta MenonFrimley Health NHS Foundation Trust, Surrey, UK.
Benjamin J L BurtonJames Paget University Hospitals NHS Foundation Trust, Norfolk, UK.ORCID http://orcid.org/0000-0001-9579-9078
James TalksNewcastle Hospitals NHS Foundation Trust, Newcastle, UK.
Anna GrabowskaKing's College Hospital NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0002-3053-2142
Faruque GhanchiBradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.ORCID http://orcid.org/0000-0002-4448-8162
Richard GaleHull York Medical School and York, University of York and Scarborough Teaching Hospital NHS Foundation Trust, York, UK.
Eleni KaratsaiNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Shruti ChandraNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.ORCID http://orcid.org/0000-0002-2634-9775
Sobha SivaprasadNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK. sobha.sivaprasad@nhs.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo study the impact of definitions of various treatment extension criteria on the proportion of patients who could be extended at their first visit after the loading phase of 2 mg aflibercept therapy for neovascular age related macular degeneration (nAMD).

methodsPatients with nAMD initiated on the loading phase of three intravitreal doses of 2 mg aflibercept in routine clinical practice were recruited from December 2019 to August 2021. The response to the loading phase was assessed at approximately 8 weeks post-loading (up to 140 days from first injection) based on different definitions of response. The proportion of patients that qualify for interval extension based on different clinical trial criteria was also evaluated.

resultsA total of 722 patients with visual acuity (VA) and optical coherence tomography (OCT) scans done at all 4 visits were included. Of these 32.4% of eyes responded with complete macular fluid resolution after the first injection with no recurrence through the loading phase (super-responders) while 26.9% had persistent macular fluid in all 4 visits (true non-responders). The rest were considered suboptimal responders. Change in VA showed marked variations within each of these categories of fluid resolution. For extension of next treatment interval, if presence of any macular fluid at the post-loading visit is the only criteria considered, about 50% could be extended to 8 weeks. If both VA worsening by ≥5 letters and a > 25 μm increase in central sub-field thickness (CST) are considered, 90% will be eligible for interval extension.

conclusionClinical trial designs and pre-defined treatment extension/shortening criteria determine the proportion of patients requiring treatment in the post-loading visit. The short and long-term impact of interval extension immediate post-loading on visual outcome in clinical practice is unknown.

Indexed as

Angiogenesis InhibitorsIntravitreal InjectionsReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsTomography, Optical CoherenceVisual AcuityWet Macular DegenerationAgedAged, 80 and overFemaleHumansMaleTreatment OutcomeVascular Endothelial Growth Factor AafliberceptAngiogenesis InhibitorsReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor A

Identifiers

PMID38710939
PMCPMC11427460

What OpenQuestion holds

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Registered trials

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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.