Continued anti-VEGF use after disease control does not prevent nAMD recurrence

In patients with neovascular age-related macular degeneration (nAMD) who achieve functional and morphological disease stability, continuing treatment with antivascular endothelial growth factors (anti-VEGF) does not substantially reduce the risk of recurrence, reports a recent study.

Researchers conducted a retrospective observational case series of 103 eyes from 103 nAMD patients who had reached stable disease after treatment. Forty-nine patients were subjected to continuous anti-VEGF treatment, administered every 12–14 weeks, whereas treatment was stopped in the remaining 54 patients, who were instead asked to undergo regular follow-ups every 8–12 weeks.

Baseline characteristics, such as age, sex distribution, and lens status, were comparable between groups. Twenty-one out of the 49 eyes that received continuous anti-VEGF eventually recurred, yielding a rate of 42.9 percent. Reactivation occurred a mean of 11.1 months after achieving stable disease.

A statistically similar recurrence rate was reported in eyes who discontinued anti-VEGF treatment (61.1 percent; n=33 of 54 eyes; p=0.08), which developed an average of 9.2 months after cessation.

Both groups were also comparable in terms of time between treatment initiation and stable disease achievement, number of visits, and visual acuity.

“Our results add to existing evidence that recurrence cannot be prevented by continuing anti-VEGF treatment after achieving stable disease and by extending the treatment interval to 12 or more weeks in a relevant portion of patients,” the researchers said. “Patients deserve to be informed of a potential lifetime risk of recurrences, even under continued therapy.”