Tailored Anti-VEGF Therapy with New Generation Optimizations (TANGO) Treatment Regimen for Neovascular Age-Related Macular Degeneration: Rationale, Design, and Simulation Study

Yousif Subhi,1– 3 Lena Michelle Mørup Andersen,1 Javad Nouri Hajari,1,2 Naayaab Henningsen,1 Karin Ingemann Larsen,1 Miklos Schneider1,2,4 1Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark; 2Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; 3Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 4Department of Ophthalmology, Semmelweis University, Budapest, HungaryCorrespondence: Yousif Subhi, Department of Ophthalmology, Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, DK-2600, Denmark, Email [email protected]: To present the rationale and design of the Tailored Anti-VEGF therapy with New Generation Optimizations (TANGO) treatment regimen for neovascular age-related macular degeneration and to simulate potential number of visits and injections with TANGO and compare to other treatment regimens.Methods: This is a descriptive short report of the rationale and design of TANGO. The purpose of TANGO is to lessen the burden of therapy with new generation anti-VEGF medications that have better durability. We also simulate the potential number of visits and injections during the first year with TANGO and compare these numbers to other treatment regimens.Results: Our report describes TANGO and provides a flow chart for its use. Our simulations suggest that TANGO may lead to a reduced number of visits and injections.Conclusion: Our simulations suggest that employing TANGO may lead to a reduced number of visits and anti-VEGF injections while still providing intensive therapy for those who require it. However, it should be emphasized that this is a descriptive report and a simulation study, and clinical real-world studies of efficacy and safety using TANGO are warranted to better understand implications of employing TANGO in routine clinical practice.Keywords: neovascular age-related macular degeneration, anti-VEGF, treatment regimen, faricimab, aflibercept, tailored anti-VEGF therapy with new generation optimizations