Translating evidence into practice: recommendations by a UK expert panel on the use of aflibercept in diabetic macular oedema.
Eye (Lond)
; 34(5): 969-981, 2020 05.
Article
em En
| MEDLINE
| ID: mdl-31619777
ABSTRACT
OBJECTIVES:
This paper describes recommendations from a panel of UK retina experts on aflibercept in diabetic macular oedema (DMO).METHODS:
A roundtable meeting was held in London, UK in March 2018. The meeting was sponsored by Bayer.RESULTS:
Recommendations are based on clinical experience and level 1 evidence. Clinical experience supports the evidence base, reinforcing that aflibercept should be initiated with intensive proactive dosing at 2 mg every 4 weeks. Most panel members use six initial 4-weekly doses as in Protocol T, rather than five initial monthly doses as recommended in the Summary of product characteristics (SmPC). After intensive proactive dosing, patients with a good response (meet Protocol T 'improvement' criteria ≥5-letter improvement in visual acuity [VA] and/or ≥10% improvement in central subfield thickness [CST] from baseline) but who are not yet stable should continue with 4-weekly aflibercept until stability is reached. Patients with a good response and stability should initiate monitor-and-extend (not in line with SmPC). Those with a sub-optimal response (meet 'improvement' criteria but with additional concerns e.g. fluid worsening on macular volume map) should continue with 4-weekly aflibercept but additional treatments should be considered (aflibercept is not licensed for combination treatment). For patients with no response (no change, or meeting Protocol T 'worsening' criteria [≥5-letter decrease in VA and/or ≥ 10% increase in CST] from baseline), switching to a non-anti-vascular endothelial growth factor treatment should be considered.CONCLUSIONS:
Clinical experience reinforces that, when using aflibercept in DMO, the licensed posology or Protocol T regimens achieve the best outcomes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Edema Macular
/
Diabetes Mellitus
/
Retinopatia Diabética
Tipo de estudo:
Guideline
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article