VEGF Trap continues to impress

VEGF Trap (Regeneron) maintains a significant improvement in the visual acuity of neovascular age-related macular degeneration (wet AMD) patients up to 32 weeks, according to a study presented at this year's Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO).

Quan Dong Nguyen, MD, MSc, of the Johns Hopkins University School of Medicine in Baltimore, US, and colleagues conducted a double-masked, prospective, randomized, multicentre, Phase II trial of five groups of a cumulative 157 patients, who each received VEGF Trap in one eye.

The first group of patients received 0.5 mg of VEGF Trap monthly for 12 weeks; Group 2 received 2.0 mg of VEGF Trap monthly for 12 weeks; Group 3 received 0.5 mg at baseline and week 12; Group 4 received 2.0 mg at baseline and week 12, and Group 5 received 4.0 mg at baseline and week 12. Follow-up PRN treatment was administered at the same dose as the patient had received in the initial 12 weeks.

Across all groups, an average of one extra injection was required throughout the follow-up period. VEGF Trap was well tolerated; no drug-related adverse serious events were noted.

Groups 1 and 2 demonstrated mean VA improvements of 8.0 and 10.1 letters, respectively. VA improvements in Groups 3, 4 and 5 were less robust, although the mean VA improvement for all groups at week 32 was 6.6 letters. These results indicate that a fixed monthly dosing is a more effective method of treating wet AMD with VEGF Trap. The full 52 week Phase II study is ongoing.

A separate study published in the March 2008 issue of the British Journal of Ophthalmology also demonstrated that VEGF Trap administered intravitreally continues to bind VEGF for 10–12 weeks following injection.

Michael W. Stewart, MD of the Mayo Clinic College of Medicine, Jacksonville, US and colleagues compared VEGF Trap with Lucentis (ranibizumab; Novartis) against VEGF. Seventy-nine days following a 1.15 mg injection of VEGF Trap, intravitreal VEGF binding was comparable to that achieved 30 days after an injection of Lucentis.