One-year data from the PLANET study show that the anti-VEGF treatment aflibercept (solution for injection into the eye) is effective as monotherapy in patients who have polypoidal choroidal vasculopathy (PCV), an important but frequently under-diagnosed subtype of wet age-related macular degeneration (AMD).
Wet AMD is a leading cause of blindness globally; in Asia Pacific, the prevalence of wet AMD is estimated to soar to 17 million in 2040 from 7 million in 2010. PCV is characterized by abnormal growth of blood vessels ending in polyps and can cause sudden and dramatic vision loss. In PCV, an excess of VEGF causes growth of abnormal blood vessels with polyps at the back of the eye.
Vascular Endothelial Growth Factor (VEGF) is a naturally occurring protein in the body. Its normal role in a healthy human being is to trigger formation of new blood vessels (angiogenesis) supporting the growth of the body’s tissues and organs. Under pathological conditions, it is also associated with the growth of abnormal new blood vessels in the eye, which exhibit increased permeability (property of a material that lets fluids to diffuse through it) leading to retinal edema (swelling caused by excess fluid). A person with PCV will see wavy lines and distorted images, and a dark spot in their central vision.
PLANET is a randomized clinical trial involving a total of 333 patients with PCV aged 50 years and older at 62 study sites in eight countries, mainly in Asia Pacific. The PLANET study showed that aflibercept improves visual acuity in PCV patients without the need for photodynamic therapy (PDT) with verteporfin, the current first-line treatment option for PCV. PDT is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. Verteporfin is a medication used as a photosensitizer for PDT.
Professor Won Ki Lee, Chief of Vitreo-retinal division, Department of Ophthalmology, Seoul St. Mary’s Hospital, The Catholic University of Korea said, “The PLANET results confirm what we have come to expect in clinical practice – that aflibercept offers strong visual and anatomic benefits in patients with PCV. Also, aflibercept monotherapy showed similar efficacy to aflibercept plus rescue PDT therapy, signifying that aflibercept monotherapy can be established as a first line treatment option for patients with visual impairment due to PCV. I look forward to seeing further outcomes from this study next year.”
A product of research-based pharmaceutical company Bayer in collaboration with Regeneron Pharmaceuticals, aflibercept is a solution for injection that works by inhibiting VEGF activity thereby blocking the growth of new blood vessels in the eye; shrinking abnormal blood vessels and polyps that have already formed; reducing swelling and leakage; and improving vision.
Results of the PLANET study have important implications in the management of PCV. Early detection and proactive, regular treatment with aflibercept monotherapy can preserve vision and inactivate polyps. Aflibercept as a monotherapy can be established as a first-line treatment option for patients with visual impairment due to PCV. Last but not the least, patients can benefit from aflibercept as a monotherapy without the additional time and associated side effects of PDT treatment.
Conditions that cause vision loss significantly impacts patients’ quality of life and puts a heavy socio-economic burden on families. Persons with vision loss are 17 times more likely to need help with home care, self-care, driving, administrative tasks, and leisure activities. They are also two times more at risk of falls. One in three will develop clinical depression, even if only one eye is affected.