Aflibercept

(Eylea®)

Eylea®

Drug updated on 12/11/2024

Dosage FormInjection (intravitreal; 2 mg/0.05 mL)
Drug ClassVascular endothelial growth factor (VEGF) inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of patients with neovascular (wet) age-related macular degeneration (AMD)
  • Indicared for the treatment of patients with macular edema following retinal vein occlusion (RVO)
  • Indicated for the treatment of patients with diabetic macular edema (DME)
  • Indicated for the treatment of patients with diabetic retinopathy (DR)
  • Indicated for the treatment of patients with Retinopathy of Prematurity (ROP).

Latest News

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Summary
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  • This summary is based on the review of 44 systematic review(s)/meta-analysis(es). [1-43]
  • Faricimab demonstrated comparable Early Treatment of Diabetic Retinopathy Study (ETDRS) letter gain outcomes to aflibercept, ranibizumab, and bevacizumab in both fixed and pro re nata (PRN) schedules. Brolucizumab showed superior best-corrected visual acuity (BCVA) improvement over aflibercept and ranibizumab in intraretinal fluid (IRF) and/or subretinal fluid (SRF) presence and serious adverse events. Aflibercept achieved similar BCVA outcomes to ranibizumab, with greater improvement in central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) subgroups and in fixed versus PRN regimens.
  • Faricimab provided similar retinal thickness outcomes to other anti-vascular endothelial growth factor (VEGF) agents but was less effective than brolucizumab in reducing retinal thickness. Brolucizumab significantly reduced central subfield thickness compared to aflibercept and ranibizumab. Aflibercept exhibited superior retinal thickness reduction over ranibizumab and bevacizumab, particularly effective in diabetic macular edema (DME) and retinal vein occlusion (RVO).
  • Faricimab required fewer injections annually compared to both fixed and flexible anti-VEGF regimens. Brolucizumab had reduced injection frequency in comparison to ranibizumab and aflibercept. Aflibercept generally required fewer injections than ranibizumab and PRN schedules.
  • Faricimab demonstrated a safety profile comparable to other anti-VEGF agents for ocular adverse events and serious ocular adverse events, with a significant reduction in the risk of serious ocular adverse events compared to brolucizumab on a quarterly basis.
  • Brolucizumab was associated with fewer serious adverse events overall compared to control groups but presented a higher incidence of serious ocular adverse events than aflibercept and ranibizumab; it was also noted for a higher incidence of severe ocular adverse events, including retinal vasculitis.
  • Aflibercept exhibited a similar overall incidence of ocular and non-ocular adverse events relative to other anti-VEGF agents, maintaining a favorable safety profile with fewer ocular adverse events compared to ranibizumab and conbercept.
  • Aflibercept demonstrated superior BCVA and CRT improvements in DME patients with poor baseline vision and showed greater BCVA and CRT efficacy in central RVO over ranibizumab, while ranibizumab showed comparable effectiveness to aflibercept in branch RVO; additionally, anti-VEGF agents, including aflibercept and bevacizumab, were effective in reducing retreatment rates and enhancing refractive outcomes in retinopathy of prematurity (ROP).

Product Monograph / Prescribing Information

Document TitleYearSource
Eylea (aflibercept) Prescribing Information.2024Regeneron Pharmaceuticals, Inc., Tarrytown, NY

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis2024 BMJ Open Ophthalmology
Efficacy and safety of Brolucizumab for neovascular age-related macular degeneration: a systematic review and meta-analysis2024 PeerJ
Comparative efficacy of anti-vascular endothelial growth factor on diabetic macular edema diagnosed with different patterns of optical coherence tomography: A network meta-analysis2024 PloS One
Efficacy, Safety, and Treatment Burden of Aflibercept 2 mg and Ranibizumab in Retinal Vein Occlusion: A Systematic Review and Meta-analysis2024 Ophthalmology and Therapy
Comparison of different agents and doses of anti-vascular endothelial growth factors (aflibercept, bevacizumab, conbercept, ranibizumab) versus laser for retinopathy of prematurity: A network meta-analysis2024 Survey of Ophthalmology
Intravitreal anti-vascular endothelial growth factor injections in pregnancy and breastfeeding: a case series and systematic review of the literature2024 Eye
Aflibercept versus ranibizumab for diabetic macular edema: A meta-analysis2024 European Journal of Ophthalmology
Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis2023 Cochrane Database of Systematic Reviews
Comparative efficacy of aflibercept and ranibizumab in the treatment of age-related macular degeneration with retinal pigment epithelial detachment: a systematic review and network meta-analysis2023 BMC Ophthalmology
Efficacy of four anti-vascular endothelial growth factor agents and laser treatment for retinopathy of prematurity: A network meta-analysis2023 Biomolecules & Biomedicine
The efficacy and ocular safety following aflibercept, conbercept, ranibizumab, bevacizumab, and laser for retinopathy of prematurity: a systematic review and meta-analysis2023 Italian Journal of Pediatrics
Comparative Efficacy, Durability and Safety of Faricimab in the Treatment of Diabetic Macular Edema: A Systematic Literature Review and Network Meta-Analysis2023 Advances in Therapy
Determining the Superiority of Vitrectomy vs Aflibercept for Treating Dense Diabetic Vitreous Hemorrhage: A Systematic Review and Meta-Analysis of Randomized Clinical Trials2023 Clinical Ophthalmology
Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis2023 Frontiers in Endocrinology
Efficacy and Safety of Brolucizumab, Aflibercept, and Ranibizumab for the Treatment of Patients with Visual Impairment Due to Diabetic Macular Oedema: A Systematic Review and Network Meta-Analysis2023 Diabetes Therapy
Anti-vascular endothelial growth factor for neovascular glaucoma2023Cochrane Database of Systematic Reviews
Anti-vascular endothelial growth factor for proliferative diabetic retinopathy2023Cochrane Database of Systematic Reviews
Role of anti-vascular endothelial growth factor in the management of non-proliferative diabetic retinopathy without centre-involving diabetic macular oedema: a meta-analysis of trials2023 Eye
A systematic review and meta-analysis of the effect of intravitreal VEGF inhibitors on cardiorenal outcomes2023 Nephrology, Dialysis, Transplantation
Comparison of adverse events between intravitreal anti-VEGF and laser photocoagulation for treatment-requiring retinopathy of prematurity: a systematic review2023 International Ophthalmology
Efficacy, safety, and treatment burden of treat-and-extend versus alternative anti-VEGF regimens for nAMD: a systematic review and meta-analysis2023 Eye
Real-World Evidence in the Management of Diabetic Macular Edema with Intravitreal Anti-VEGFs in Asia: A Systematic Literature Review2022 Clinical Ophthalmology
Efficacy and Safety of Aflibercept Therapy for Diabetic Macular Edema: A Systematic Review and Meta-Analysis2022 Journal of Current Ophthalmology
Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: a systematic review and meta-analysis2022 International Journal of Retina and Vitreous
Comparison of intravitreal aflibercept and dexamethasone implant in the treatment of macular edema associated with diabetic retinopathy or retinal vein occlusion: a Meta-analysis and systematic review2022 International Journal of Ophthalmology
A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity2022Ophthalmology
Different Anti-Vascular Endothelial Growth Factor for Patients With Diabetic Macular Edema: A Network Meta-Analysis2022 Frontiers in Pharmacology
Comparative Efficacy of Brolucizumab in the Treatment of Neovascular Age-Related Macular Degeneration: A Systematic Literature Review and Network Meta-Analysis2022 Advances in Therapy
The Efficacy and Safety of Brolucizumab for the Treatment of nAMD: A Systematic Review and Meta-Analysis2022 Frontiers in Pharmacology
Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis2022 Frontiers in Medicine
Cost-effectiveness analysis of brolucizumab versus aflibercept for the treatment of neovascular age-related macular degeneration (nAMD) in Italy2022BMC Health Services Research
Frequency of Intravitreal Anti-VEGF Injections and Risk of Death: A Systematic Review with Meta-analysis2022 Ophthalmology Retina
Effect of Anti-VEGF Therapy on the Disease Progression of Neovascular Age-Related Macular Degeneration: A Systematic Review and Model-Based Meta-Analysis2022 Journal of Clinical Pharmacology
Anti-vascular endothelial growth factor therapy for age-related macular degeneration: a systematic review and network meta-analysis2021 Systematic Reviews
Managing Diabetic Macular Edema in Clinical Practice: Systematic Review and Meta-Analysis of Current Strategies and Treatment Options2021 Clinical Ophthalmology
Intravitreal anti-vascular endothelial growth factors, panretinal photocoagulation and combined treatment for proliferative diabetic retinopathy: a systematic review and network meta-analysis2021 Acta Ophthalmologica
Anti-vascular endothelial growth factor for macular oedema secondary to branch retinal vein occlusion2020Cochrane Database of Systematic Reviews
Comparative Safety of Bevacizumab, Ranibizumab, and Aflibercept for Treatment of Neovascular Age-Related Macular Degeneration (AMD): A Systematic Review and Network Meta-Analysis of Direct Comparative Studies2020 Journal of Clinical Medicine
Treatment regimens for administration of anti-vascular endothelial growth factor agents for neovascular age-related macular degeneration2020Cochrane Database of Systematic Reviews
Efficacy of switching therapy to aflibercept for patients with persistent diabetic macular edema: a systematic review and meta-analysis2020 Annals of Translational Medicine
Efficacy and Treatment Burden of Intravitreal Aflibercept Versus Intravitreal Ranibizumab Treat-and-Extend Regimens at 2 Years: Network Meta-Analysis Incorporating Individual Patient Data Meta-Regression and Matching-Adjusted Indirect Comparison2020 Advances in Therapy
Efficacy of Conversion to Aflibercept for Diabetic Macular Edema Previously Refractory to Bevacizumab or Ranibizumab: A Meta-analysis of High-Quality Nonrandomized Studies2020 The Annals of Pharmacotherapy
Real-World Effectiveness and Real-World Cost-Effectiveness of Intravitreal Aflibercept and Intravitreal Ranibizumab in Neovascular Age-Related Macular Degeneration: Systematic Review and Meta-Analysis of Real-World Studies2020 Advances in Therapy

Clinical Practice Guidelines