New options under study, but for now anti-VEGF monotherapy remains gold standard for wet AMD

Anti-VEGF-A therapy will never completely go away for the treatment of neovascular age-related macular degeneration, but new therapies that improve the efficacy and durability of treatment are needed to help bridge the results between clinical data and real-life results for patients.
VEGF-A suppression will not be abandoned, but researchers and ophthalmologists need to find a new way to increase efficacy and the durability of treatment to better serve patients diagnosed with wet AMD, OSN Retina/Vitreous Board Member Pravin U. Dugel, MD, said.
“I do think it’s important to recognize that VEGF-A suppression will never go away. It will always be the crux of our treatment strategy. If the Ophthotech study and the Regeneron study teach us anything, they teach us what a very high hurdle we must overcome to do better than anti-VEGF-A monotherapy. … I think there is great opportunity to add on another agent for combination therapy that will either get us a greater durability or greater efficacy, and either of those two, but particularly both of those two, will help us close the delta,” Dugel said.

“The gap between real-world results and pristine clinical data has never been larger than it is now, according to Pravin U. Dugel, MD.”
A treatment delta exists

The gap between real-world results and pristine clinical data has never been larger than it is now, Dugel said.
When there is such a difference between how patients are treated in a trial and how patients are actually treated in the real world, the treatment gap becomes “bigger and bigger, and that is a dangerous sign for our community and in our field,” Dugel said.
The delta exists in two “silos,” Dugel said, a logistical silo and a physiological silo.
Clinical trials, for instance, suggest patients diagnosed with wet AMD should be given an anti-VEGF-A drug once a month, or every 4 weeks….
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Source: Healio