Aflibercept (Eylea) treatment of neovascular (wet) age-related macular degeneration (wAMD)
Age-related macular degeneration (AMD) is a degenerative disease of the macula. In Canada, about one million people currently have early AMD and approximately 250,000 have the advanced form of AMD. AMD is the leading cause of registered visual impairment in Canada. The prevalence of blindness due to...
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| Format: | eBook |
| Language: | English |
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Ottawa (ON)
Canadian Agency for Drugs and Technologies in Health
2015, 2015
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| Series: | Common drug review clinical review report
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| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | Age-related macular degeneration (AMD) is a degenerative disease of the macula. In Canada, about one million people currently have early AMD and approximately 250,000 have the advanced form of AMD. AMD is the leading cause of registered visual impairment in Canada. The prevalence of blindness due to AMD in Canada has been estimated at more than 100,000. There are two types of AMD: dry AMD and neovascular (wet) AMD (wAMD). While wAMD develops in only 10% to 20% of people with dry AMD, it accounts for more than 90% of those who have advanced vision loss. The hallmark of wAMD is choroidal neovascularization, which is an abnormal angiogenic process modulated by growth factors including vascular endothelial growth factor (VEGF). Currently, there is no cure for wAMD. The goal of treatment is to minimize vision loss and disability in order to maintain independence. Aflibercept is supplied as a solution for IVT injection (40 mg/mL) at a dose of 2 mg every eight weeks after three initial monthly injections. The objective of this report was to review the beneficial and harmful effects of aflibercept at the dosing regimen recommended by Health Canada for the treatment of wAMD. The first line of pharmacological therapy for wAMD in Canada is 0.5 mg ranibizumab, a monoclonal antibody that inhibits VEGF and that is administered monthly by intravitreal (IVT) injection. Pegaptanib and photodynamic therapy (PDT) using verteporfin are also indicated for the treatment of wAMD in Canada, but as these treatments are limited to stabilization of the disease and produce little to no improvement in vision, they are generally used as a second-line therapy in clinical practice. For instance, PDT is usually reserved for patients with wAMD for whom IVT injection is not suitable. Bevacizumab is a much larger antibody fragment derived from the same parent antibody as ranibizumab. It is not approved for treatment of wAMD in Canada, although it is used off-label for treating wAMD in patients who are ineligible for ranibizumab treatment coverage. Aflibercept (Eylea) is a novel VEGF inhibitor that is indicated in Canada for the treatment of patients with wAMD. |
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| Physical Description: | 1 online resource illustrations |