Aflibercept effective but concerns raised over long-term use

Aflibercept is effective in inhibiting vascular endothelial growth factor (VEGF) for a prolonged period of time, but possible side effects draw concerns about its long-term use in patients with age-related macular degeneration, diabetic macular oedema and retinal vein occlusion, according to the conclusions of a new study.

To compare the effectiveness of aflibercept to VEGF-antagonists ranibizumab and bevacizumab, the authors treated porcine RPE/choroid organ cultures with 125 μg/mL of one of the three drugs, and they evaluated the VEGF content of the supernatant over 7 days. They also measured the minimal concentration of VEGF inhibition in the organ cultures 6 hours after application.

Aflibercept completely inhibited VEGF detection for 6 hours at a minimal concentration of 0.031 μg/mL. By comparison, the necessary concentration of bevacizumab was 3.9 μg/mL, and the needed ranibizumab concentration was 0.244 μg/mL. Regarding aflibercept and ranibizumab, a statistically significant VEGF inhibition compared with the control could be found down to and including 0.031 μg/mL. Bevacizumab, by comparison, was significantly reduced compared with the control down to a concentration of 0.244 μg/mL and also at 0.061 μg/mL.

VEGF was inhibited after one aflibercept application of 125 μg/mL over the course of the 7 days; the investigators detected some VEGF on the last day. By comparison, the researchers detected VEGF after 72 hours of ranibizumab treatment and after 12 hours of bevacizumab treatment.

To read the abstract of the study, visit Graefe's Archive for Clinical and Experimental Ophthalmology.