Triple therapy viable option for anti-VEGF non-responders

Triple therapy for age-related macular degeneration (AMD) can stabilize vision and reduce the re-treatment rate in patients who do not respond to initial anti-VEGF therapy, according to a poster submitted to the American Society of Retina Specialists 2007 annual meeting.

Allan Franklin, MD and colleagues designed a three-part treatment protocol involving injections of triamcinolone and bevacizumab, followed by short-duration photodynamic therapy (PDT). A total of 27 patients were treated with the protocol.

At one-year follow-up, it was found that approximately 40% of patients required one re-treatment with a combination intravitreal injection and 11% required two to three combination injections or repeated triple therapy. Eleven percent of patients required three or more re-treatments and were considered refractory to triple therapy. Overall, patients demonstrated a stabilization in vision during the first 12 months follow-up.

Fourteen patients were available for a longer follow-up period and, of these, three gained at least three lines of vision, three lost three lines or more and vision remained stable in the remaining eight.

It is thought that triple therapy of this kind could offer a viable option in patients who are not rapid responders to anti-VEGF therapy alone.