Most patients in the maintenance phase of a treat-and-extend regimen for AMD continue to require treatment approximately every 8 weeks, according to this analysis of data from a large international voluntary registry of neovascular AMD.
While there is little debate about the best approach to the induction phase of a treatment treat-and-extend regimen, the maintenance phase presents the physician with numerous subtle variations. This analysis provides further information to support clinicians’ treatment decisions.
The authors found that mean visual acuity was well maintained out to 3 years, while median injection interval progressively increased from 35 days at study entry to 63 days at 12 months and levelled off at 60 days at 36 months. The most common treatment interval at first recurrence was 8 weeks and treatment intervals >12 weeks appeared to be associated with an increased risk of disease reactivation.
Also evaluated was the question of whether the number of injections required to render the lesion inactive during the induction phase (≤3 or >3) was predictive of subsequent lesion behavior. Longer duration of induction phase was associated with worse visual acuity outcomes and earlier disease reactivation, which the authors say is likely due to undertreatment.