In the latest issue of Ophthalmic Surgery, Lasers & Imaging Retina, Texas Retina’s Ashkan M. Abbey, MD, co-authored a retrospective study evaluating the effectiveness of high-dose aflibercept 8 mg (Eylea HD) in treating diabetic macular edema (DME) in patients who previously had suboptimal responses to faricimab-svoa (Vabysmo).
Understanding Diabetic Macular Edema
As the number of adults living with diabetes continues to grow, so does the prevalence of DME. This condition develops when damaged blood vessels in the retina leak fluid into the macula—the central part of the retina responsible for sharp, detailed vision. Without treatment, DME can lead to significant vision impairment.
Treatment has traditionally included intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) medications, which help reduce fluid leakage and slow abnormal blood vessel growth. One of the most commonly used treatments has been aflibercept 2 mg (Eylea).
In 2022, the U.S. Food and Drug Administration (FDA) approved faricimab-svoa (Vabysmo), a bispecific antibody administered through intravitreal injection that targets both VEGF and angiopoietin-2 (Ang-2). In the pivotal Phase III YOSEMITE and RHINE clinical trials, which supported its approval, faricimab-svoa demonstrated noninferior visual acuity outcomes and favorable anatomic outcomes compared with aflibercept 2 mg. Studies comparing faricimab-svoa with ranibizumab, another anti-VEGF medication, also demonstrated favorable visual and anatomic outcomes, with the potential for longer intervals between treatments.
More recently, the FDA approved a high-dose, 8-mg formulation of aflibercept (Eylea HD). Clinical trials demonstrated that aflibercept 8 mg could achieve comparable anatomic outcomes to aflibercept 2 mg while allowing for longer treatment intervals of 12 or 16 weeks in appropriate patients.
About the New Study
This new retrospective study included patients with DME treated at Texas Retina and Mid Atlantic Retina at Wills Eye Hospital who had previously received faricimab-svoa. Dr. Abbey and his fellow researchers evaluated treatment intervals, best-corrected visual acuity, and central foveal thickness before and after patients switched to aflibercept 8 mg.
No significant anatomic or visual changes were observed following the switch. Importantly, patients maintained the extended injection intervals they had achieved with their previous treatment through their final aflibercept 8 mg injection.
“What’s encouraging is that patients maintained visual and anatomic stability even as the time between treatments increased,” shares Dr. Abbey. “This suggests that aflibercept 8 mg may help reduce the burden of frequent appointments while continuing to deliver consistent results. That said, we still need more research, including head-to-head clinical trials, to better understand how it compares with faricimab-svoa and to evaluate its long-term benefits and safety.”
Access the published abstract.
About Dr. Abbey
Dr. Abbey serves as Texas Retina’s Director of Clinical Research for Dallas and is actively involved in advancing retinal research and evaluating emerging treatments for retinal diseases. He cares for patients at Texas Retina’s Dallas Main and Rockwall offices.