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Background and Importance Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the standard of care for neovascular age-related macular degeneration (nAMD). Aflibercept 2 mg (AFLI2) is widely used but requires frequent administration, imposing a substantial treatment burden. The newer aflibercept 8 mg (AFLI8) formulation offers the potential to extend dosing intervals while maintaining therapeutic efficacy.Aim and Objectives To analyse different aflibercept treatment schemes in patients with neovascular age-related macular degeneration (nAMD) and compare their efficiency.Material and Methods This retrospective observational study was carried out in a tertiary hospital between January and September 2025. Patients were grouped according to treatment scheme: (1) aflibercept 2 mg (AFLI2), (2) aflibercept 8 mg (AFLI8-naïve), (3) those transitioned from AFLI2 to AFLI8 (AFLI2+AFLI8). Data were extracted from electronic medical records and pharmacy dispensing databases, including demographic characteristics, treatment intervals, number of injections, and acquisition costs. Descriptive statistics were used for data analysis.Results Sixty-seven patients were included (47,7% male), with a median age of 72 years (47–96).AFLI2 group (13,4%): all received three monthly loading doses followed by 8–week intervals. Median number of injections: six (2–6); mean cost per patient: €1.537.AFLI8–naïve group (22,3%): all received loading doses; 46,6% followed a treat–and–extend regimen (26,6% every 12 weeks, 20% every 10 weeks). Median injections: three (2–4); mean cost: €864.AFLI2+AFLI8 group (64,3%): 67,4% had an induction phase; 44,9% followed treat–and–extend (24,3% every 10 weeks, 20,6% every 12 weeks). The remaining 32,6% had no loading doses, with intervals of 14 (38,5%), 10 (30,8%), or 8 (30,7%) weeks. Median injections: three (2–5); mean cost: €810.Conclusion and Relevance AFLI8 reduced injection frequency and mean treatment cost per patient compared with AFLI2, enabling longer treatment intervals through treat-and-extend regimens. These findings indicate that AFLI8 is an efficient therapeutic alternative, optimising healthcare resources and potentially enhancing patient quality of life. These real-world findings align with the results of the pivotal PULSAR trial. 1 References and/or Acknowledgements 1. Lanzetta P, Korbelnik JF, Heier JS, Leal S, Holz FG, Clarck WL, Eichenbaum D, lida T, Xiaodong S, Berliner AJ, et al. Intravitreal aflibercept 8 mg in neovascular age-related macular degeneration (PULSAR): 48-week results from a randomised, double-masked, non-inferiority, phase 3 trial. Lancet 2024;403(10432):1141–1152.Conflict of Interest No conflict of interest