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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-08-2020 | Macular Degeneration | Retinal Disorders

A Trinity regimen with aflibercept for treatment-naïve neovascular age-related macular degeneration: 2-year outcomes

Authors: Makiko Wakuta, Nanami Nomi, Tadahiko Ogata, Manami Ota, Chiemi Yamashiro, Makoto Hatano, Ryoji Yanai, Kazuhiro Tokuda, Kazuhiro Kimura

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 8/2020

Abstract

Purpose

To evaluate the advantages of the Trinity regimen for treatment-naïve neovascular age-related macular degeneration (nAMD).

Methods

Thirty-one treatment–naïve nAMD eyes were treated using the Trinity regimen with an intravitreal aflibercept injection (IVA) and evaluated after 24 months. Three treatment methods, pro re nata (PRN), treat and extend (TAE), and fixed regimen were changed depending on recurrence frequency. After the initial treatment, PRN or TAE (started for 4 or 8 weeks) was selected as per the recurrence interval. Subsequently, the recurrence interval became constant, transitioning from a TAE to fixed regimen. When the recurrence frequency became irregular, the treatment regimen was changed to TAE.

Results

After the initial treatment, 15 eyes (48.4%) were allocated to the PRN group, 12 (38.7%) to the TAE 8-week group, and 4 (12.9%) to the TAE 4-week group. Mean logMAR significantly improved in all cases, 0.53 ± 0.40 at baseline to 0.36 ± 0.34 at 24 months (p < 0.01), in the PRN group (0.63 ± 0.46 to 0.42 ± 0.43, p < 0.01), and the TAE 8-week group (0.44 ± 0.29 to 0.27 ± 0.19, p < 0.05). LogMAR in the TAE 4-week group was maintained. The mean number of injections for all and in the PRN, TAE 8-week, and TAE 4-week groups were 9.7, 5.3, 13.1, and 15.8, respectively, with the PRN group being significantly less (p < 0.01).

Conclusion

The Trinity regimen delivered the benefits of the PRN, TAE, and FIXED regimens while minimizing injections during the early treatment phase without visual loss.

Trial registration

This trial was registered with the University Hospital Medical Information Network (UMIN ID: 000038335).

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Title: A Trinity regimen with aflibercept for treatment-naïve neovascular age-related macular degeneration: 2-year outcomes
Authors: Makiko Wakuta
Nanami Nomi
Tadahiko Ogata
Manami Ota
Chiemi Yamashiro
Makoto Hatano
Ryoji Yanai
Kazuhiro Tokuda
Kazuhiro Kimura
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Macular Degeneration
Aflibercept
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 8/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-020-04745-1

At a glance: The STEP trials

Springer Medicine

A Trinity regimen with aflibercept for treatment-naïve neovascular age-related macular degeneration: 2-year outcomes

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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