Efficacy and safety of intravitreal aflibercept injection in wet age-related macular degeneration
Reviewed by Jonathan Chan

This is a sub-group study of double masked review of patients randomised to different dosages and treatment frequency compared between aflibercept and ranibizumab treatment. This is to evaluate the efficacy and safety of intravitreal aflibercept (IVT-AFL) in Japanese patients with wet age-related macular degeneration (AMD) from the VIEW 2 trial. Patients were randomised to: 0.5mg IVT-AFL every four weeks; 2mg IVT-AFL every four weeks; 2mg IVT-AFL every four weeks after three monthly injections; or 0.5mg ranibizumab every four weeks. The main efficacy outcomes included vision maintenance and best corrected visual acuity (BCVA) at week 52. The VIEW 2 trial was a prospective, double-masked, multinational, active-controlled, randomised, clinical trial. Eligible patients had sub-foveal choroidal neovascularisation (CNV) or juxta foveal CNV with subfoveal leakage demonstrated on fluorescein angiogram (FA) with appropriate lesion characteristics. Since polypoidal choroidal vasculopathy (PCV) is considered to be part of the AMD spectrum, patients with PCV lesions were not excluded. All Japanese patients in the IVT-AFL groups (n=70) at week 52 maintained vision, compared with 96% of Japanese patients (n=23/24) treated with ranibizumab. Japanese patients in all treatment groups show improvement in BCVA after treatment. Those treated at four weekly intervals with ranibizumab, compared with aflibercept treated at four weekly intervals and also eight weekly intervals, experienced similar gains in BCVA from baseline. The 0.5mg group had higher gains due to an unexpected drop in BCVA between screening and baseline. The central retinal thickness and mean area of choroidal neovascularisation decreased in all treatment groups with similar magnitude. The ocular treatment – adverse events were similar across the treatment groups. The authors concluded that IVT-AFL was effective and well tolerated in Japanese patients. The outcomes of this sub-group population were consistent with those in the overall VIEW 2 trial study of other population subjects. 

Efficacy and safety of intravitreal aflibercept injection in wet age-related macular degeneration: outcomes in the Japanese subgroup of the VIEW 2 study.
Ogura Y, Terasaki H, Gomi F, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2015;99:92-7.