Wet AMD tx new option to shorten Eyelea's minimum cycle

Interval 8 weeks → Reduced to 4 weeks

Jang Woo-hyuk, ophthalmologist, "Applied to patients who develop resistance or have poor efficacy through long-term treatment"

Bayer's macular degeneration treatment Eyelea took the lead in establishing an optimized treatment strategy for patients by shortening the minimum treatment cycle.

 

It is evaluated that a new option was presented in macular degeneration treatment that determines the treatment cycle according to the patient's condition.

 

According to the pharmaceutical industry on the 6th, Eylea's minimum administration interval has recently been shortened from 8 weeks to 4 weeks.

 

Accordingly, medical staff can increase the treatment interval from at least 4 weeks to up to 16 weeks through monitoring after injection once a month for the first three months of treatment with Eyelea.

 

As T&E therapy is widely used in macular degeneration treatment, the medical staff believes that there is room for reducing the minimum dose interval to address the unmet demand.

 

T&E therapy is a method of monitoring patients after initial three-month treatment and adjusting the treatment interval.

 

It is a widely used treatment method around the world by overcoming the shortcomings of the post-treatment method, such as PRN therapy, which is more efficient than fixed treatment cycles and continues treatment when symptoms worsen.

 

Dailypharm listened to the meaning of changing minimum administration cycle of Eyelea through Director Jang Woo-hyuk.

 

Director Jang served as a clinical doctor at the Wills Eye Institute at Thomas Jefferson University in Philadelphia and a professor at the ophthalmology department at Yeungnam University University.

 

Director Jang Woo-hyuk

Macular degeneration begins with dryness and progresses into habit.

 

Dry macular degeneration is a stage in which only wastes accumulate in the retina.

 

When waste accumulates and oxygen permeation becomes difficult, new blood vessels are created to forcibly supply oxygen.

 

In the process, abnormal neoplasms bleed and exudates leak out.

 

This stage is wet macular degeneration.

 

Failure to receive proper treatment can lead to blindness.

 

The number of patients with habitual macular degeneration is also rapidly increasing due to rapid aging.

 

Director Jang said, "There are overwhelmingly many elderly patients in the clinical field.

 

This is because aging is the biggest cause of wet macular degeneration.

 

Environmentally Westernized eating habits and the increase in adult diseases are also affecting it, he explained.

 

The most important goal of treating wet macular degeneration is to preserve vision that can maintain the quality of life.

 

Therefore, it can be seen that the core of the treatment is to restore vision as much as possible with initial active treatment and then maintain vision at least with damage.

 

The drug mainly used for treatment is an anti-VEGF injection.

 

Representative treatments include Eylea and Lucentis, and recently Beovu has also emerged as new treatment options.

 

The medical staff determines the drug according to the patient's condition because the medication cycle varies slightly from drug to drug.

 

According to IQVIA, a pharmaceutical market research firm, Eyelea is the treatment that generates the most sales in Korea, recording sales of 70.5 billion won last year.

 

In response to the recent reduction in the minimum administration interval for Eyelea to four weeks, Director Jang said, "There was clearly a need for injections at clinical sites at shorter intervals than eight weeks.

 

Even after injection treatment every eight weeks, there are no signs of deterioration, no improvement, or persistent exudation causes vision to gradually decrease," he said.

 

"In the past, in this case, we had no choice but to use off-label drugs or increase the dose, but even this was not very effective.

 

The reduction of the minimum administration interval of Eylea to four weeks is a very welcome change," he said.

 

Reducing the administration interval to 4 weeks mainly occurs in long-term treatment.

 

This is because the drug's effectiveness decreases even if it is injected every eight weeks because of long treatment.

 

"There are few patients who need to be treated every four weeks from the beginning.

 

If resistance develops or the effectiveness of the drug decreases after a year or two of treatment, we will consider shortening the interval," he added.

 

In order to perform only four-week intervals, anatomical examinations must show clear deterioration.

 

There are still ambiguous situations where it is difficult to boldly apply the four-week interval.

 

Director Jang explained, "This is the case when it continues to not deteriorate when it is done every eight weeks, or when there are findings of exudation in monitoring, it is better than eight weeks ago." He said, "At this time, medical staff tend to worry about reducing the interval to four weeks and then reducing the benefit.

 

Since the four-week interval has not been long since it was applied, it is difficult to reduce it to four weeks unless there are clear deterioration findings," he said.

 

Patients with good treatment effects are treated by widening the interval to a maximum of 16 weeks.

 

According to Director Jang, about 20 to 30% of all patients show good treatment results, extending it to 16 weeks.

 

"The longer the injection period is, the more patients are satisfied.

 

There may be anxiety about watching without treatment for four months, but experience has shown that the symptoms rarely worsen severely among patients who have extended it to 16 weeks.

 

If there is any recurrence, the interval will be reduced by two weeks again, he said.