GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
Abstract
Key messages: What is known • Anti-VEGF therapy is the cornerstone of neovascular AMD treatment, but frequent intravitreal injections are required due to the short half-life and rapid ocular clearance of these agents. What is new • The newly available 8 mg aflibercept formulation exhibits a 34.4% slower ocular clearance compared to the standard 2 mg dose, exceeding predictions based on a simple dose increase. • Pharmacokinetic modeling demonstrates that this reduced clearance extends VEGF suppression duration up to 20 weeks, aligning with clinical outcomes from the PULSAR trial. • The enhanced durability of aflibercept 8 mg appears to be driven by formulation differences, increased viscosity, and altered intravitreal distribution dynamics, offering the potential for extended treatment intervals.
