¹Chiemsee Augen Tagesklinik, Prien
²Retina Specialists of Beverly Hills, Beverly Hills, USA
³Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
⁴Vestrum Health, Naperville, IL, USA
⁵Cleveland Clinic Martin Hospitals, Cleveland Clinic Florida, Stuart, FL, USA
⁶New York Medical College, Administration Building, Valhalla, NY, USA
⁷Duke University Eye Center, Durham, NC, USA
⁸Byers Eye Institute at Stanford University, Stanford School of Medicine, Palo Alto, CA, USA
⁹NYU Langone Health, Department of Ophthalmology, New York, NY, USA

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Purpose: To describe the real-world treatment (tx) patterns among previously treated anti-VEGF-users initiating aflibercept (AFL) 8 mg for the tx of DME.

Methods: Separate cohorts of previously treated eyes with DME initiating AFL 8 mg were created from electronic health records in the Intelligent Research in Sight (IRIS)^® registry and Vestrum Health Retina Databases (Vestrum). Eyes initiating AFL 8 mg during 8/18/23–6/30/24 (IRIS) and 8/18/23–7/30/24 (Vestrum) were followed from initiation until last visit, tx switch or missing information on tx laterality. Mean dosing intervals were calculated during the pre-AFL 8 mg switch period (≥6 months up to 1 year), loading phase (i.e. first 3 injections or 90 days, whichever occurred first) and post-loading phase (up to end of follow-up). Dosing intervals were examined before and after switching to AFL 8mg in a subset of eyes that were consistently anti-VEGF-treated prior to switching, (defined as tx for ≥6 months and average dosing intervals of ≤8 weeks) with average dosing intervals before switching of 4–<6 or 6–≤8-weeks.

Results: A total of 9.109 and 3.722 eyes initiating AFL 8 mg were included (median [Q1, Q3] months of follow-up of 3 [2, 5] and 5 [3, 8]) from IRIS and Vestrum, respectively. Patient characteristics at time of switch from IRIS and Vestrum were similar: mean age 66 years; ~56% were men, ~62% were white, and ~90% had bilateral DME. Nearly 73% switched from AFL 2 mg and 14% from faricimab. In consistently anti-VEGF-treated eyes with ≥1 post-loading phase injection (IRIS, n=1.593; Vestrum, n=427), last post-loading dosing interval was on average (mean [std]) 16 (23) and 19 (20) days longer than last observed dosing interval prior to switching, respectively. In consistently anti-VEGF-treated eyes with average pre-switch injection interval of 4–<6 weeks in IRIS (n=742) and Vestrum (n=168), dosing intervals were extended by mean (SD) of 20 (21) and 24 (20) days, respectively. In eyes with average pre-switch injection interval of 6–≤8 weeks in IRIS (n=849) and Vestrum (n=259), mean interval (SD) extension was 13 (24) and 16 (20) days, respectively.

Conclusion: Early real-word experience suggests dosing intervals could be extended by 2 or more weeks among DME eyes that were consistently anti-VEGF-treated prior to initiating AFL 8 mg, with most switching from AFL 2 mg or faricimab.

This abstract has been recently submitted and will be presented at the 2025 annual meeting of the Association for Research in Vision and Ophthalmology (ARVO).