Primary objective: • To evaluate the change in aqueous humor vascular endothelial growth factor A (VEGF-A) levels after 2 months of initial treatment with 8 mg Aflibercept in treatment-naïve nAMD patients. Secondary objectives: • To assess the efficacy, safety, and biomarker changes of 8 mg Aflibercept using a modified fixed-interval dosing regimen over 12 months in treatment-naïve nAMD patients.
Age-related macular degeneration (AMD) is a disease that affects the central part of the retina (the macula) and can lead to loss of central vision in older adults. In developed countries, this condition is the leading cause of central vision loss in this population. AMD has two clinical subtypes: dry and wet (neovascular) forms. The dry type is characterized by progressive accumulation of drusen, with secondary degeneration of the retinal pigment epithelium and photoreceptors; the wet type is characterized by retinal edema and neovascularization, which can lead to severe vision loss. Wet AMD is the main cause of most AMD-related blindness cases. Inhibiting vascular endothelial growth factor (VEGF) activity with medication has been proven to be an effective therapeutic strategy for treating nAMD. In addition to Eylea® (Aflibercept) injection, multiple anti-VEGF drugs have been approved for nAMD treatment in various countries globally, such as Lucentis® (Ranibizumab), Conbercept, and Faricimab (Vabysmo®). Most nAMD patients require long-term chronic treatment. Although globally approved intravitreal (IVT) anti-VEGF therapies are effective and well tolerated, the need for frequent IVT injections (especially during the maintenance phase) places a significant burden on physicians, patients, and caregivers. Currently, in China, local reimbursement policies for nAMD cover nine anti-VEGF injections, and patients must bear the cost for any additional treatments. As a chronic progressive disease, nAMD patients typically require longer-term management and more anti-VEGF therapies. Limitations in insurance reimbursement are a primary obstacle in clinical practice. At the same time, anti-VEGF therapy requires a three-dose loading regimen (once per month), with frequent follow-up and a complex injection schedule, which imposes a significant financial burden on patients, increases treatment costs for physicians, results in low patient adherence, and ultimately reduces long-term visual benefits. A result from the Barometer global survey indicated that 95.2% of physicians and 83.9% of patients believe that improving the predictability of injection timing is the main direction for enhancing patient care.
Study Type
INTERVENTIONAL
All treatment-naïve nAMD patients who have completed screening and meet the eligibility criteria will be included in this study. Aflibercept 8 mg will be administered at Month 0, Month 2, Month 5, Month 8, and Month 11. A rescue treatment follow-up will be conducted at Month 1, and if the criteria for rescue treatment are met, one rescue treatment (Aflibercept 8 mg injection) will be given.
VEGF-A levels in the patient's aqueous humor
In the second month, the average change in VEGF-A levels in the patient's aqueous humor relative to baseline
Time frame: From enrollment to the end of treatment at 0 months、2months、5months、8months、11months
Proportion of patients who did not receive remedial treatment
Proportion of patients who did not receive remedial treatment within 12 months
Time frame: From enrollment to the end of treatment at 12 months
best corrected visual acuity (BCVA)
At month 12, the changes in the patient's best corrected visual acuity (BCVA) relative to baseline
Time frame: From enrollment to the end of treatment at 12 months
central retinal thickness (CMT)
At month 12, the changes in the patient's central retinal thickness (CMT) relative to baseline
Time frame: From enrollment to the end of treatment at 12 months
VEGF-B levels in the patient's aqueous humor
In the second month, the average change in VEGF-B levels in the patient's aqueous humor relative to baseline
Time frame: From enrollment to the end of treatment at 0 months、2months、5months、8months、11months
placental growth factor (PIGF) levels in the patient's aqueous humor
In the second month, the average change in placental growth factor (PIGF) levels in the patient's aqueous humor relative to baseline
Time frame: From enrollment to the end of treatment at 0 months、2months、5months、8months、11months
Ang-2 levels in the patient's aqueous humor
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Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
49
In the second month, the average change in Ang-2 levels in the patient's aqueous humor relative to baseline
Time frame: From enrollment to the end of treatment at 0 months、2months、5months、8months、11months
IL-6 levels in the patient's aqueous humor
In the second month, the average change in IL-6 levels in the patient's aqueous humor relative to baseline
Time frame: From enrollment to the end of treatment at 0 months、2months、5months、8months、11months
IL-8 levels in the patient's aqueous humor
In the second month, the average change in IL-8 levels in the patient's aqueous humor relative to baseline
Time frame: From enrollment to the end of treatment at 0 months、2months、5months、8months、11months
Average number of doses in the 12th month
Average number of doses in the 12th month
Time frame: "From enrollment to the end of treatment at 12 months
the average area/volume of macular neovascularization (MNV)
At each key visit time point, the relative change from baseline in the average area/volume of macular neovascularization (MNV) in patients ...
Time frame: From enrollment to the end of treatment at 0 month、2months、5months、8months、11months
intraretinal fluid (IRF) or subretinal fluid (SRF) in the foveal area
Percentage of patients with no intraretinal fluid (IRF) or subretinal fluid (SRF) in the foveal area at months 0, 2, and 12
Time frame: From enrollment to the end of treatment at 2months、12months