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  • Aflibercept demonstrates long-term efficacy for polypoidal choroidal vasculopathy

    Retina/Vitreous

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    This prospective phase 3b/4 study assessed the long-term efficacy and safety of intravitreal aflibercept with or without rescue photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV).

    Study design

    The PLANET study was a multicenter, double-masked, sham-controlled randomized clinical study that spanned 62 centers. All patients initially received 3 monthly injections of 2 mg aflibercept. At week 12, they were randomized to either continue aflibercept therapy alone (n=157 patients) or aflibercept plus rescue PDT (n=161). The primary outcome was mean BCVA change from baseline.

    Outcomes

    At week 96, aflibercept monotherapy was noninferior to aflibercept plus PDT in terms of ETDRS letters gained (+10.7 vs +9.1 letters; P=0.48). Through 96 weeks, both cohorts received an average of 4.6 injections and approximately 82% to 85% of patients had no active polypoidal lesions.

    There was no significant difference in BCVA in the subgroup requiring rescue PDT (n=54). Both groups showed similar adverse events.

    Limitations

    The low number of patients requiring rescue PDT makes it difficult to gauge its benefit in conjunction with aflibercept. Additionally, there were no standardized criteria for PCV diagnosis.

    Clinical significance

    Through 96 weeks of follow-up, aflibercept monotherapy was noninferior to aflibercept with rescue PDT in patients with polypoidal choroidal vasculopathy. A minority of patients required rescue PDT, which ultimately provided no additional visual benefit.