nAMD patients successfully switch from aflibercept to biosimilar ranibizumab

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A recent study showed that patients with neovascular age-related macular degeneration (nAMD) who transition from aflibercept to biosimilar ranibizumab maintained visual acuity and macular anatomy despite changes in fluid management.

The study,¹ published in Clinical Ophthalmology, was a multicenter observational study on patients over the age of 50 with nAMD. Patients were shifted from intravitreal aflibercept to biosimilar ranibizumab due to financial constraints.

In total, 29 eyes were analyzed, 12 male and 17 female, with a mean age of 72.55 ±6.43 years. Eyes were disqualified for analysis if they had co-existing diabetic retinopathy, retinal vein occlusion, or glaucoma.¹

Change in best corrected visual acuity (BCVA) before and after switching was the primary outcome measure, while changes in central macular thickness (CMT) from baseline to follow-up at 12 months were measured as secondary outcomes.

Initial treatment with aflibercept saw a significant improvement in visual acuity (VA), with a mean increase from 55.0 ± 10.2 to 70.0 ± 8.5 ETDRS letters at the switch time point (p < 0.01). At the time of the switch from aflibercept to biosimilar ranibizumab, a slight decrease was seen, to 62.3 ± 8.9 at 12 months.¹

Mean CMT decreased notably from 400 ± 50 to 290 ± 45 μm at the switch, while the final CMT at 12 months after switching was 280 ± 40 μm (p < 0.01). The authors noted that there was a significant decrease in the retinal and intra-retinal fluid during treatment with aflibercept, followed by a gradual increase after the switch. The authors also noted that a significant correlation (p < 0.05) was noted between the presence of intraretinal fluid and increased injection frequency of biosimilar ranibizumab.¹

The authors concluded that the switch from aflibercept biosimilar ranibizumab in patients with nAMD demonstrated efficacy in maintaining the VA and macular anatomy, with some changes in fluid management needed.

References:

1. Chakraborty D, Boral S, Sinha TK, et al. Transitioning from Aflibercept to Biosimilar Ranibizumab in Neovascular AMD (The TRANSFORM Trial): A Multicenter Observational Study. Clin Ophthalmol. 2024;18:1819-1828. Published 2024 Jun 24. doi:10.2147/OPTH.S459085