Neovascular AMD: Less-Frequent Dosing With Conbercept
By Lynda Seminara
Selected By: Richard K. Parrish II, MD
Journal Highlights
American Journal of Ophthalmology, December 2018
Download PDF
Monthly intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs are the standard treatment for choroidal neovascularization in age-related macular degeneration (AMD). However, the frequent visits can be burdensome. Liu et al. tested less-frequent treatment intervals for conbercept, a new anti-VEGF drug, and found the regimen to be effective and well tolerated.
This prospective, double-masked, sham-controlled, phase 3 PHOENIX trial was conducted at 9 sites in the People’s Republic of China from 2011 to 2013. Participants (N = 124) were ≥50 years old with a best-corrected visual acuity (BCVA) ranging from 19 to 73 letters. They were assigned randomly (2:1) to receive either 3 monthly injections of 0.5-mg conbercept followed by quarterly injections until month 12 (n = 81) or 3 monthly sham injections plus 3 monthly doses of 0.5-mg conbercept followed by quarterly administration of the agent until month 12 (n = 43). The main outcome was mean change in BCVA score from baseline to month 3. Tolerability also was assessed.
Baseline demographics and ocular characteristics were similar for the study groups. Overall, 123 patients completed the initial 3 months of treatment, and 113 patients completed the full 12 months. The mean number of injections within 12 months was 5.8 in the conbercept group and 4.8 in the sham group. From baseline to 3 months, the mean change in BCVA score was +9.20 in the conbercept group and +2.02 in the sham groups. From 3 to 12 months, the mean additional changes were +0.78 and +6.76, respectively. In general, both treatments were well-tolerated. The most common adverse ocular events in both groups were injection-site hemorrhage, conjunctivitis, reduced VA, and elevated intraocular pressure.
Because no significant between-group differences in VA or central retinal thickness were noted at 12 months (once all patients had received 3 monthly injections of conbercept), the authors focused on the first 3 months, when improvement in VA occurred quickly for the conbercept group. They suggested that the long half-life and strong bioavailability of conbercept support a quarterly dosing schedule.
The original article can be found here.