Optimizing Anti-VEGF Treatment Outcomes in Neovascular AMD and DME - Episode 11

Long-Term Treatment Experience with Aflibercept

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Experts discuss the long-term efficacy and safety of aflibercept in the treatment of neovascular age-related macular degeneration (nAMD).


Ehsan Rahimy, MD: Aflibercept has been the market leader for some time—well over a decade. Jon, what do we know about the long-term real-world efficacy and the safety of aflibercept?

Jonathan Jonisch, MD: We touched on this before. We’re fortunate in our community that we’ve had patients being treated with anti-VEGF therapy repeatedly, year after year, for over 20 years. The eye does remarkably well, and the patients remain largely very compliant. Systemically, we haven’t had major red flags. The bar is set high, and aflibercept has taken the lead since it was approved about 12 years ago. [It has] rapidly gained market share and has been the leader for the last 10 years. The bar is set high for newer medicines because of how safe and effective it is over a wide course of disease.

The convenience that we have in our clinic with prefilled syringes has come such a long way from where we started that so many of our patients are being extended way longer than a month. [Sometimes it’s 2, 3, or 4] months, as we alluded to. The eye seems to tolerate it, and the body seems to tolerate it. It’s that anti-VEGF ceiling that we’d all like to break through and see better long-term visual gains across a number of our diseases. But from a durability point of view, the newer medications have to prove to be more durable than aflibercept in order to knock it off the mountain.

Transcript edited for clarity.