Journal Article Ahead of print
PubMed: 42684442 DOI: 10.1007/s00417-026-07470-3
Aflibercept 8 mg for diabetic macular edema and neovascular age-related macular degeneration: an italian expert consensus paper.
Graefes Arch Clin Exp Ophthalmol
Authors: Francesco Bandello, Enrico Borrelli, Sandro De Falco, Alessandro Invernizzi, Paolo Lanzetta, Marco Lupidi, Edoardo Midena, Federico Ricci
Affiliations
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Department of Surgical Sciences, University of Turin, Turin, Italy.
- Department of Ophthalmology, "City of Health and Sciences" Hospital, Turin, Italy.
- Angiogenesis Laboratory, Institute of Genetics and Biophysics 'Adriano Buzzati- Traverso' - CNR, Naples, Italy.
- Eye Clinic, Ospedale Luigi Sacco, Milan, Italy.
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
- Department of Medicine - Ophthalmology, University of Udine, Udine, Italy.
- Istituto Europeo di Microchirurgia Oculare - IEMO, Udine, Italy.
- Eye Clinic, Department of Experimental and Clinical Medicine, Polytechnic University of Marche, Ancona, Italy.
- Department of Neuroscience-Ophthalmology, University of Padova, Padova, Italy.
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy.
Abstract
PURPOSE
To provide consensus recommendations on the clinical use of aflibercept 8 mg in managing neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) in the real-world setting.
METHODS
A modified Delphi study was undertaken, involving ophthalmologists from specialized centers in Italy, to gauge consensus on statements related to the use of aflibercept 8 mg in nAMD and DME. Two initial rounds of online surveys were conducted, followed by 2 workshops to assess the clinical feasibility of selected statements and identify the behavioral drivers and barriers to their adoption in practice. Consensus was defined as ≥ 75% agreement ('strongly agree' or 'somewhat agree').
RESULTS
Consensus was reached for 30 initial statements, following refinement and discussion. Of these, 12 statements were analyzed and discussed at the behavioral workshop. Statements covered clinical differentiation of aflibercept 2 mg and 8 mg, treatment initiation in aflibercept-naïve patients, switching to aflibercept 8 mg, optimal aflibercept 8 mg maintenance, and safety considerations. There was expert group consensus that aflibercept 8 mg represents a viable treatment option with an extended injection interval for patients with nAMD or DME, with the possibility of improving treatment adherence, and therefore outcomes. Experts also discussed practical considerations in Italy and offered evidence-based guidance.
CONCLUSION
Experts agreed that aflibercept 8 mg is a treatment option for both nAMD and DME with the potential to improve treatment adherence. Although real-world data are limited, experts offered guidance on the management of nAMD and DME in the context of aflibercept 8 mg.
MeSH
Macular Degeneration, Treatment Adherence And Compliance, Ophthalmology, Macular Edema, Therapeutics, Edema