Aflibercept increases retinal nonperfusion in eyes with proliferative diabetic retinopathy: Study

Texas: Aflibercept 2mg, administered intravitreal monthly or quarterly resulted in a significant increase in retinal nonperfusion (RNP) in patients with proliferative diabetic retinopathy (PDR), reports data from year 2 of the RECOVERY trial published in the journal Ophthalmology Retina. 

Diabetic retinopathy is a microvascular complication of diabetes caused by damage to the blood vessels of the retina in the eye. Retinal nonperfusion (RNP) is an important biomarker for diabetic retinopathy (DR). Anti-vascular endothelial growth factor therapy, also known as anti-VEGF therapy or anti-VEGF medication, blocks vascular endothelial growth factors. Data suggest that consistent anti-VEGF pharmacotherapy (Aflibercept ) can slow RNP development, reduce the severity of diabetic retinopathy, and is associated with lower rates of proliferative diabetic retinopathy development.

The RECOVERY trial was conducted by Wykoff CC, Houston Methodist Hospital & Weill Cornell Medical College, Texas, and his research team to evaluate the impact of aflibercept (Eylea, Regeneron) on RNP among eyes with proliferative DR (PDR).

Researchers included participants with proliferative diabetic retinopathy and retinal nonperfusion for a prospective, randomized clinical trial with treatment crossover in the second year. At baseline, the subjects were randomized 1:1 to monthly (arm 1) or quarterly (arm 2) intravitreal 2 mg aflibercept. At the beginning of the second year, the treatment arms were crossed over so that the monthly-dosed subjects subsequently received quarterly dosing and vice versa. The primary outcome was a change in total RNP area (mm2) through year 2. Secondary outcomes included Diabetic Retinopathy Severity Scale (DRSS) scores; best-corrected visual acuity; central subfield thickness; additional measures of RNP, including ischemic index (ISI); and adverse event incidence.