Half of pts with macular degeneration have ↓ effect

Expecting a new treatment

600 domestic patients who have received existing anti-VEGF treatment are conducting a real world study

In 58% of patients, retinal exudate remains even after one year of treatment, resulting in poor vision improvement

Researchers expect the new VEGF inhibitor Beovu to address unmet demand.

 

Patients with neovascular age-related macular degeneration in Korea had more than half of retinal exudates at the time of one year of treatment, indicating that the vision improvement effect was not significant.

 

It was found in PROOF, which evaluated the retinal exudate regulation effect of the first year of existing VEGF inhibitor treatment in age-related macular degeneration patients.

 

The results of the PROOF study, in which 12 domestic ophthalmic medical staff, including Kim Jae-hwi, a specialist at Kim's eye clinc, participated as the author, were published in the Scientific Reports on August 19.

 

According to the study, more than half of the age-related macular degeneration patients in Korea treated with existing VEGF inhibitors such as Lucentis and Eylea remained retinal exudates until the first year of treatment, and their vision improvement effects were relatively poor.

 

The PROOF study is a retrospective study based on the medical records of 600 age-related macular degeneration patients who visited ophthalmology hospitals in Korea from January 2017 to March 2019.

 

The primary evaluation index is the proportion of patients with retinal exudations such as intra-retinal fluid/retinal subcutaneous fluid in the first year of treatment.

 

In the early stages of treatment, 97.2% of patients had retinal exudate, and the rate after one year was 58.1%.

 

The intra-retinal fluid, sub-retinal fluid, and retinal pigment epithelial fluid remained in 24.7%, 37.6%, and 21.2%, respectively.

 

The proportion of patients with retinal exudate in the second year (24 months) of treatment reached 66.0%.

 

In the first year of treatment, patients who did not have retinal effusions adjusted showed better eyesight improvement compared to those who did not.

 

Patients with continuous retinal exudation control for a long period of time until the first year of treatment also showed better vision improvement effects.

 

Whether retinal exudates remain is a major factor affecting vision improvement.

 

Retinal exudates are frequently observed through optical tomography in age-related macular degeneration patients.

 

Some studies have shown that if a new retinal exudate occurs during treatment, vision is likely to decrease by more than five characters.

 

Retinal exudation is considered a sign of disease activity and requires additional VEGF inhibitor treatment.

 

The researchers explained, "In actual clinical sites, there is a burden of treatment of existing VEGF inhibitors due to problems such as frequent administration and frequent hospital visits, and patients are not seeing the optimal treatment effect from a long-term perspective." Accordingly, it is expected that new anti-VEGF treatment therapy will be expected to help solve the unmet demand by reducing the burden of treatment with a prolonged mechanism of action.

 

The researchers mentioned Beovu as a new anti-VEGF treatment.

 

Brolusizumab is an antibody fragment drug that inhibits all VEGF-A isomorphic proteins.

 

In phase 3 clinical trials, the Blucizumab 6mg dose group showed better disease control effects, including superior retinal exudation control effects compared to the Aflibercept 2mg group.

 

After administration of loading dose, the Aflibercept group was administered every 8 weeks, while more than 50% of the Brolucizumab group was administered every 12 weeks.

 

Kang Se-woong, an ophthalmologist at Samsung Medical Center at Sungkyunkwan University, said, "The emergence of anti-VEGF treatments has lowered the rate of blind or vision-damaged patients, but there is still an unmet demand for retinal exudation." He said, "We welcome the introduction of new and diverse treatment options to clinical sites and hope that this will help address unmet demand and ultimately prevent patients from impaired vision."