4CPS-138 Number of annual injections with ranibizumab or aflibercept in treating neovascular age-related macular degeneration (NAMD). A comparison using real-world data

<h3>Background and Importance</h3> The standard of care for nAMD uses anti-vascular endothelial growth factor (anti-VEGF) drugs: ranibizumab or aflibercept. The current fixed injection intervals strain ophthalmology services and burden patients. A proactive treatment and extension regimen (T&amp;E) was introduced to address this. This approach consists of fixed treatment doses until disease remission occurs. Then, the therapy interval is progressively extended until disease reactivation. One prospective randomised clinical trial compared aflibercept and ranibizumab regarding the number of injections in twelve months in patients with nAMD treated with a T&amp;E approach.¹ No difference was found in this outcome. <h3>Aim and Objectives</h3> Our study aimed to acknowledge the distribution of aflibercept and ranibizumab among patients treated at our hospital for nAMD and compare the number of injections in twelve months of treatment between both drugs. We also sought to compare this data with the number of injections reported in the twelve-month clinical trial.¹ <h3>Material and Methods</h3> This observational retrospective study included patients with nAMD treated with a single drug (ranibizumab or aflibercept) from May 2023 to June 2024. Additional inclusion criteria were receiving an injection at least 11 months (330 days) before June 2024 and another during the last 6 months (180 days). Data were retrieved from pharmacy dispensation records. The primary outcome was the number of injections in twelve months of treatment. <h3>Results</h3> All 121 included in the cohort were treated using the T&amp;E approach. Of these, 95 (78,5%) received aflibercept and 26 (21,5%) ranibizumab. No differences between drugs were detected in the mean number of injections per year: 5,00±1,4 for aflibercept and 4,85±1,16 for ranibizumab (p=0,616, t-test for unpaired samples). In the reference clinical trial (1), these numbers were higher (9,7±2,6 and 9,7±2,8, respectively). <h3>Conclusion and Relevance</h3> In our hospital, aflibercept is used four times more than ranibizumab as a single anti-VEGF drug, and no significant difference between drugs was found in the mean number of injections in twelve months. This number was inferior to the corresponding data previously reported by Gillies et al. <h3>References and/or Acknowledgements</h3> Gillies MC <i>et al</i>. Effect of ranibizumab and aflibercept on best-corrected visual acuity in treat and extend for neovascular age-related macular degeneration: a randomized clinical trial. <i>JAMA Ophthalmol</i>. 2019;<b>137</b>(4):372–379. <h3>Conflict of Interest</h3> No conflict of interest