ASRS 2024: Aflibercept 8 mg and 2 mg, DME, and IOP outcomes in the phase 2/3 PHOTON trial

In this video, Jordana Fein, MD, MS, speaks about data she presented at the American Society of Retina Specialists meeting in Stockholm, Sweden. The findings focused on the IOP outcomes with aflibercept 8 mg and 2 mg in patients with DME through week 48 of the phase 2/3 PHOTON trial.

Editor's note: The below transcript has been lightly edited for clarity.

Jordana Fein, MD, MS: Good morning, my name is Jordana Fein. I have the privilege of presenting on behalf of the PHOTON investigators. I'm from the Retina Group of Washington in Fairfax, Virginia. Today I'm going to talk about intraocular pressure outcomes in patients with 8 mg versus 2 mg aflibercept through week 48. In the PHOTON trial, this was a post-hoc analysis of the PHOTON IOP data specifically to investigate whether using 8 mg aflibercept, which is 70 microliters in injection volume, versus aflibercept 2 mg, which is 50 microliters in injection volume, made any difference in intraocular pressure.

So this post-hoc analysis looked at patients in the 8 mg aflibercept arm and the 2 mg aflibercept arm as well as untreated fellow eyes as comparator. In summary, what we found is that baseline IOP and 48 week IOP had no significant difference, plus or minus one millimeter of mercury throughout in all the treatment arms, suggesting no study eye or fellow eye drift in IOP over time.

Additionally, if we look at the patients who had glaucoma, which was about 8% of the patients included in the study, there was no statistically significant drift in IOP over time. In patients without a history of glaucoma at baseline, about 1.1% of patients in the 8 mg arm required addition of an IOP lowering drop versus 1.0% in the 8 mg arm, which was not statistically significant.

So in terms of IOP lowering procedures through week 48, the only IOP lowering procedures are performed were AC taps at the time of the individual injection. There were 3 of these in total. Two of them were in the 8 mg aflibercept arm and 1 was in the fellow eye 2 mg treated aflibercept arm. So in summary, mean change in pre-dose IOP. In the study eye versus the fellow eye did not change significantly plus or minus one millimeter of mercury, the proportion of study and fellow eyes that required an IOP lowering medication was low and similar across treatment groups.