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Assessing New Therapies for Retinal Diseases

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Panelists discuss how anti-VEGF therapies have dramatically improved visual outcomes in patients with age-related macular degeneration and diabetic macular edema over the past decade. Key challenges persist, including treatment burden, adherence, and identifying optimal dosing regimens for individual patients.

Evolution of Anti-VEGF Agents and Unmet Needs in Retinal Diseases

Panelists discuss how aflibercept’s molecular structure contributes to its clinical efficacy as a standard treatment for retinal vascular diseases.

Advantages of the Molecular Structure of Aflibercept

Panelists discuss how treat-and-extend dosing with aflibercept 2 mg allows for individualized treatment intervals while maintaining vision gains. However, optimal extension timing must be carefully determined based on disease activity markers.

Treat-and-Extend Strategy With Aflibercept 

Panelists discuss how aflibercept 8 mg demonstrates improved durability and maintenance of visual gains compared with 2-mg dosing, potentially reducing treatment burden while maintaining a similar safety profile.

Panelists discuss how the aflibercept 8 mg higher molecular concentration enables extended durability through increased VEGF binding capacity and longer intraocular drug levels, potentially allowing for less frequent dosing while maintaining efficacy.

Significance of the Higher Molar Dose of Aflibercept 8 mg

Panelists discuss how the phase 3 PULSAR and PHOTON trials demonstrated the efficacy of aflibercept 8 mg through a design comparing 12- and 16-week dosing intervals to the aflibercept 2 mg standard 8-week dosing, with primary end points assessing noninferiority in visual acuity maintenance.

Study Design for PULSAR and PHOTON Trials for Aflibercept 8 mg

Panelists discuss how ideal candidates for aflibercept 8 mg include patients with stable disease on current anti-VEGF therapy who seek reduced treatment burden, newly diagnosed patients, and those demonstrating good response to initial loading doses.

Patient Selection for Aflibercept 8 mg

Panelists discuss how faricimab’s bispecific antibody design uniquely targets both VEGF-A and Ang-2 pathways, addressing the complementary role of Ang-2 in vascular destabilization and inflammation in retinal diseases.

Faricimab Molecular Design and Role of Ang-2

Panelists discuss how faricimab’s dual inhibition of Ang-2 provides additional benefits in vascular stability and inflammation reduction beyond VEGF-A suppression alone, potentially leading to improved durability and treatment outcomes in selected patients.

Outcomes with Raricimab and Choosing Between the New Therapies

Panelists discuss how both medications demonstrate favorable safety profiles in clinical trials, with aflibercept 8 mg benefiting from extensive 2-mg safety data, while acknowledging the need to monitor intraocular pressure due to increased injection volume, particularly in at-risk patients.

Safety Profile of New Therapies

Panelists discuss how real-world evidence provides crucial insights into treatment effectiveness across diverse patient populations and clinical settings while highlighting challenges in maintaining clinical trial protocols’ stringent adherence and monitoring in everyday practice.

Perspectives on the Usefulness of Real-world Data

Panelists discuss how loading doses remain crucial for treatment-naive patients to achieve rapid disease control, while patients switching therapies may require modified approaches based on their prior treatment response and disease activity.

Strategies for Loading Dose Sse for Treatment-Naive and Switch Patients

Panelists discuss how longer-acting treatments will enable extended intervals between visits while requiring careful adjustment of monitoring protocols and clinic workflows to balance reduced treatment burden with maintaining adequate disease surveillance.

Impact of Durable Therapies on Patients and Clinics and Monitoring Strategies

The Ophthalmology Times Europe® Viewpoints program facilitates roundtable discussions with experts of the ophthalmic community to explore a variety of disease focused topics. Areas of discussion include diagnosis & treatment, patient journey, treatment planning, treatment options, and genetic testing.

Assessing New Therapies for Retinal Diseases

EP: 1.Evolution of Anti-VEGF Agents and Unmet Needs in Retinal Diseases

EP: 2.Advantages of the Molecular Structure of Aflibercept

EP: 3.Treat-and-Extend Strategy With Aflibercept

EP: 4.Assessing New Therapies for Retinal Diseases

EP: 5.Significance of the Higher Molar Dose of Aflibercept 8 mg

EP: 6.Study Design for PULSAR and PHOTON Trials for Aflibercept 8 mg

EP: 7.Patient Selection for Aflibercept 8 mg

EP: 8.Faricimab Molecular Design and Role of Ang-2

EP: 9.Outcomes with Raricimab and Choosing Between the New Therapies

EP: 10.Safety Profile of New Therapies

EP: 11.Perspectives on the Usefulness of Real-world Data

EP: 12.Strategies for Loading Dose Sse for Treatment-Naive and Switch Patients

EP: 13.Impact of Durable Therapies on Patients and Clinics and Monitoring Strategies

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