An Open Label-study to Compare the Efficacy of Aflibercept Monotherapy for Polypoidal Choroidal Vasculopathy
Status:
Completed
Trial end date:
2021-01-31
Target enrollment:
Participant gender:
Summary
Polypoidal choroidal neovasculopathy (PCV) is a subtype of wet age related macula
degeneration (AMD) occuring more commonly in the Asian population. Besides the phenotypic
differences, PCV is thought to have a lesser response to anti VEGF therapy which is the
mainstay of treatment for other typical wet AMD. Recent trial data suggest that a combination
with photodynamic therapy may help in the visual and anatomical outcome of PCV, and emerging
evidence shows favourable outcomes the newer anti VEGF agent, aflibercept 2mg monotherapy.
These trials however, have assessed aflibercept in a strict 2mg every 8 weekly regime.
In the clinical setting, a significant an unmet need in the management of PCV is a tailored
treatment regime. Here we propose a treatment regimen based on disease activity for PCV with
aflibercept mono therapy. A limitation of the 2q8 regime is that it is fixed and does not
vary regardless of polyp closure or anatomical outcome at the first time point of assessment
(month 3). We hypothesize that after the initial 3 monthly injections of aflibercept, about
50% of PCV will close and become quiescent, and in the remaining 50%, a further 3 monthly
injections will increase overall polyp closure rate. After a loadings phase of either 3 or 6
months, all eyes will start on a treat and extend regime (T&E), with a minimum period of 8
weeks and a maximum of 12 weeks between treatments with 2 week increments if PCV remains
quiescent. The proposed study aims to evaluate the efficacy of a modified treat and extend
regime based on disease activity with aflibercept monotherapy for PCV.