Neovascular age-related macular degeneration (nAMD) is an advanced form of macular degeneration that historically has accounted for the majority of vision loss related to AMD. Current treatment consists of injecting inhibitors of vascular endothelial growth factor (VEGF) into the vitreous cavity to interfere with proliferation of choroidal neovascularization and to reduce vascular permeability. It was a pleasure to speak with Dr Jordana Fein (Retina Group of Washington Fairfax, VA, USA) around the treatment paradigm for nAMD and their limitations.
The presentation entitled ‘Additional visual and anatomic outcomes of intravitreal aflibercept injection 8 mg versus 2 mg: a post hoc analysis of the Phase 2 CANDELA study’ was presented at the Association for Research in Vision and Ophthalmology Annual Meeting, May 05-09, 2023
Questions:
- Could you give us a brief overview of the treatment paradigm for neovascular age-related macular degeneration (nAMD)? (0:19)
- What are the limitations of current therapeutic options for nAMD? (1:40)
Disclosures: Jordana Fein has nothing to disclose in relation to this video interview.
Support: Interview and filming supported by Touch Medical Media Ltd. Interview conducted by Shanice Allen.
Filmed in coverage of the virtual ARVO 2023.
Click here for more content on nAMD.
Transcript
Hi, good afternoon. My name is Jordana Fein. I’m with the Retina Group of Washington, located primarily in Fairfax, Virginia.
Could you give us a brief overview of the treatment paradigm for neovascular age-related macular degeneration (nAMD)?
Quite a lengthy topic in quite a short period of time. But you know, as we’re all familiar with the landscape for neovascular AMD has greatly evolved in the past decade with the advent of anti-VEGF therapy and treat and extend approach is routinely utilized to try to achieve maximal benefit while balancing the burden of long term treatment. You know, I think that in clinical practice, you know, we have found that often the way that we treat patients may not be completely in line with what was done in clinical trials. And so try and extend is an approach that has been utilized to try to, you know, get patients the injections they need and to prolong the interval between injections. There are many medications on the market. As you know, we have Avastin, which is off label. We have Lucentis or ranibizumab. We have aflibercept standard dose on the market, 2 milligrams. And of course, we also have faricimab, which is an anti-VEGF and Ang-2 inhibitor, which came out in the past year.
What are the limitations of current therapeutic options for nAMD?
So I think the biggest limitation is that the outcomes that we see in clinical trials are really often not reflective of our real world practice due to that lack of consistent follow up and the high treatment burden that’s required for our patients and for our providers in order to get that clinical improvement that we see in the clinical trials. So I think the major unmet need remains for ways to optimize therapies with less frequent dosing because we know that current standard anti-VEGF therapy, you know, does work well, it just requires, you know, significant treatments to be effective.
Subtitles and transcript are autogenerated
