Aflibercept

(Eylea®)

Eylea®

Drug updated on 4/17/2024

Dosage FormInjection (intravitreal; 2 mg/0.05 mL)
Drug ClassVascular endothelial growth factor inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • For the treatment of patients with neovascular (wet) age-related macular degeneration (AMD).
  • For the treatment of patients with macular edema following retinal vein occlusion (RVO).
  • For the treatment of patients with diabetic macular edema (DME).
  • For the treatment of patients with diabetic retinopathy (DR).
  • For the treatment of patients with Retinopathy of Prematurity (ROP).

Summary
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  • Aflibercept (Eylea) is used for the treatment of patients with neovascular (wet) age-related macular degeneration, macular edema following retinal vein occlusion, diabetic macular edema, diabetic retinopathy, and Retinopathy of Prematurity.
  • Information was derived from 58 systematic reviews/meta-analyses focused on various aspects of Eylea's effectiveness and safety.
  • In comparison to ranibizumab and bevacizumab, aflibercept shows a slight but possibly clinically insignificant superiority in improving best-corrected visual acuity at 12 months. This advantage persists at 24 months as well.
  • For polypoidal choroidal vasculopathy, evidence regarding aflibercept's efficacy remains inconclusive, although it is suggested to improve anatomical outcomes.
  • Aflibercept has shown potential in reducing the number of injections needed when utilizing a Treat & Extend regimen in Diabetic Macular Edema, thereby possibly decreasing treatment burden while maintaining efficacy in visual and anatomical outcomes.
  • Significant improvements were observed across diverse populations, including variations by baseline disease severity and prior treatment efficacy, suggesting broad applicability for aflibercept.
  • Evidence on its use in Retinopathy of Prematurity calls for further exploration due to unique patient demographic considerations specific to this condition.
  • Across various conditions treated with aflibercept, there was no significant increase noted in all-cause mortality or serious adverse events compared to other VEGF inhibitors, indicating a comparable safety profile.
  • The risk associated with arterial thromboembolic events did not suggest an increase relative to controls; however, the quality of evidence supporting this claim ranged from low to very low, necessitating careful monitoring during real-world practice.
  • Further studies are required, especially direct head-to-head comparisons with long-term follow-up, which will help elucidate the optimal positioning within the treatment landscape for retinal diseases using aflibercept (Eylea).

Product Monograph / Prescribing Information

Document TitleYearSource
Eylea (aflibercept) Prescribing Information.2023Regeneron Pharmaceuticals, Inc., Tarrytown, NY

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Anti‐vascular endothelial growth factor for diabetic macular oedema: A network meta‐analysis2023Cochrane Database of Systematic Reviews
Anti‐vascular endothelial growth factor for proliferative diabetic retinopathy.2023Cochrane Database of Systematic Reviews
Comparative Efficacy, Durability and Safety of Faricimab in the Treatment of Diabetic Macular Edema: A Systematic Literature Review and Network Meta-Analysis.2023Advances in Therapy
Efficacy and safety of anti-vascular endothelial growth agents for the treatment of polypoidal choroidal vasculopathy: A systematic review and meta-analysis.2023Survey of Ophthalmology
Efficacy and safety of brolucizumab, aflibercept, and ranibizumab for the treatment of patients with visual impairment due to diabetic macular oedema: A systematic review and network meta-analysis.2023Diabetes Therapy
Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: A meta-analysis.2023Frontiers in Endocrinology
Treat and extend regimen for diabetic macular oedema - a systematic review and meta-analysis.2023Graefe's Archive for Clinical and Experimental Ophthalmology
The efficacy and ocular safety following aflibercept, conbercept, ranibizumab, bevacizumab, and laser for retinopathy of prematurity: A systematic review and meta-analysis.2023Italian Journal of Pediatrics
Determining the Superiority of Vitrectomy vs Aflibercept for Treating Dense Diabetic Vitreous Hemorrhage: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.2023Clinical Ophtalmology
Role of anti-vascular endothelial growth factor in the management of non-proliferative diabetic retinopathy without centre-involving diabetic macular oedema: A meta-analysis of trials.2023Eye
Comparative efficacy of aflibercept and ranibizumab in the treatment of age-related macular degeneration with retinal pigment epithelial detachment: A systematic review and network meta-analysis2023BMC Ophthalmology
Efficacy of four anti-vascular endothelial growth factor agents and laser treatment for retinopathy of prematurity: A network meta-analysis.2023Biomolecules & Biomedicine
Comparison of adverse events between intravitreal anti VEGF and laser photocoagulation for treatment requiring retinopathy of prematurity: A systematic review.2023International Ophthalmology
Efficacy, safety, and treatment burden of treat-and-extend versus alternative anti-VEGF regimens for nAMD: A systematic review and meta-analysis.2023Eye
Effect of anti-VEGF therapy on the disease progression of neovascular age-related macular degeneration: A systematic review and model-based meta-analysis.2022The Journal of Clinical Pharmacology
Comparative effectiveness of intravitreal anti-vascular endothelial growth factor therapies for managing neovascular age-related macular degeneration: A meta-analysis.2022Journal of Clinical Medicine
The 12- and 24-month effects of intravitreal ranibizumab, aflibercept, and bevacizumab on intraocular pressure: A network meta-analysis.2022Ophthalmology
Comparison of intravitreal aflibercept and dexamethasone implant in the treatment of macular edema associated with diabetic retinopathy or retinal vein occlusion: A meta-analysis and systematic review.2022International Journal of Ophthalmology
Efficacy and safety of aflibercept therapy for diabetic macular edema: A systematic review and meta-analysis.2022Journal of Current Ophthalmology
Comparative efficacy of brolucizumab in the treatment of neovascular age-related macular degeneration: A systematic literature review and network meta-analysis.2022Advances in Therapy
Real-World Evidence in the Management of Diabetic Macular Edema with Intravitreal Anti-VEGFs in Asia: A Systematic Literature Review.2022Clinical Ophthalmology
Pro re nata versus fixed aflibercept regimen for neovascular age-related macular degeneration: A systematic review and meta-analysis.2022International Journal of Retina and Vitreous
Different Anti-Vascular Endothelial Growth Factor for Patients With Diabetic Macular Edema: A Network Meta-Analysis.2022Frontiers in Pharmacology
Association Between Visual Acuity and Residual Retinal Fluid Following Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-analysis.2022JAMA Ophtalmology
Safety and Outcomes of Intravitreal Aflibercept in Diabetic Macular Edema - A Systematic Review.2022Current Pharmaceutical Design
Managing Neovascular Age-Related Macular Degeneration in Clinical Practice: Systematic Review, Meta-Analysis, and Meta-Regression.2022Journal of Clinical medicine
Relationship Between Macular Thickness and Visual Acuity in the Treatment of Diabetic Macular Edema With Anti-VEGF Therapy: Systematic Review.2022Journal of Vitreoretinal Diseases
Switching between anti-VEGF agents in the management of refractory diabetic macular edema: A systematic review.2022Survey of Ophthalmology
Anti-Vascular Endothelial Growth Factor Treatment Compared with Steroid Treatment for Retinal Vein Occlusion: A Meta-Analysis.2022Ophthalmologica
Efficacy and safety of brolucizumab in age-related macular degeneration: A systematic review of real-world studies.2022Acta Ophthalmologica
A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity.2022Ophthalmology
The Efficacy and Safety of Brolucizumab for the Treatment of nAMD: A Systematic Review and Meta-Analysis.2022Frontiers in Pharmacology
Intravitreal Anti-vascular Endothelial Growth Factor Injection for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis.2022Frontiers in Medicine
Treat-and-extend versus alternate dosing strategies with anti-vascular endothelial growth factor agents to treat center involving diabetic macular edema: A systematic review and meta-analysis of 2,346 eyes.2022Survey of Ophthalmology
Disease stability and extended dosing under anti-VEGF treatment of exudative age-related macular degeneration (AMD) — a meta-analysis.2021Graefe's Archive for Clinical and Experimental Ophthalmology
Efficacy and safety of anti–vascular endothelial growth factor monotherapies for neovascular age-related macular degeneration: A mixed treatment comparison. 2021Frontiers in Pharmacology
Anti-vascular endothelial growth factor therapy for age-related macular degeneration: A systematic review and network meta-analysis.2021Systematic Reviews
Managing diabetic macular edema in clinical practice: Systematic review and meta-analysis of current strategies and treatment options.2021Clinical Ophthalmology
Aflibercept for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis.2021Ophthalmic Surgery, Lasers and Imaging Retina
Treat-and-Extend Regimens for the Management of Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy: Consensus and Recommendations From the Asia-Pacific Vitreo-retina Society.2021Asia-Pacific journal of Ophthalmology
Managing Diabetic Macular Edema in Clinical Practice: Systematic Review and Meta-Analysis of Current Strategies and Treatment Options.2021Clinical Ophthalmology
Intravitreal anti-vascular endothelial growth factors, panretinal photocoagulation and combined treatment for proliferative diabetic retinopathy: A systematic review and network meta-analysis.2021Acta Ophtamologica
Antivascular Endothelial Growth Factor Dosing And Expected Acuity Outcome At 1 Year.2021Retina
How Successful is Switching from Bevacizumab or Ranibizumab to Aflibercept in Age-Related Macular Degeneration? A Systematic Overview.2020Advances in Therapy
Efficacy of switching therapy to aflibercept for patients with persistent diabetic macular edema: A systematic review and meta-analysis.2020Annals of Translational Medicine
Comparative safety of bevacizumab, ranibizumab, and aflibercept for treatment of neovascular age-related macular degeneration (AMD): A systematic review and network meta-analysis of direct comparative studies.2020Journal of Clinical Medicine
Comparative efficacy and safety of anti-vascular endothelial growth factor regimens for neovascular age-related macular degeneration: Systematic review and Bayesian network meta-analysis.2020Therapeutic Advances in Chronic Disease
Efficacy of conversion to aflibercept for diabetic macular edema previously refractory to bevacizumab or ranibizumab: A meta-analysis of high-quality nonrandomized studies.2020The Annals of Pharmacotherapy
Anti-vascular endothelial growth factor for macular oedema secondary to branch retinal vein occlusion.2020The Cochrane Database of Systematic Reviews
Treatment regimens for administration of anti-vascular endothelial growth factor agents for neovascular age-related macular degeneration.2020The Cochrane Database of Systematic Reviews
Efficacy and treatment burden of intravitreal aflibercept versus intravitreal ranibizumab treat-and-extend regimens at 2 years: Network meta-analysis incorporating individual patient data meta-regression and matching-adjusted indirect comparison.2019Advances in Therapy
A meta‐analysis of patients with treatment‐resistant macular oedema secondary to retinal vein occlusions following switching to aflibercept.2019Acta Ophthalmologica
One year effectiveness study of intravitreal aflibercept in neovascular age-related macular degeneration: A meta-analysis.2019Acta Ophthalmologica
Anti-vascular endothelial growth factor treatment for retinal conditions: A systematic review and meta-analysis.2019BMJ Open
Comparative effectiveness and harms of intravitreal antivascular endothelial growth factor agents for three retinal conditions: A systematic review and meta-analysis.2019The British Journal of Ophthalmology
Aflibercept versus dexamethasone for macular edema secondary to central retinal vein occlusion.2019Medwave
Intravitreal Medications for Retinal Vein Occlusion: Systematic Review and Meta-analysis.2019Journal of Ophthalmic & Vision Research
Current Outcomes of Anti-VEGF Therapy in the Treatment of Macular Oedema Secondary to Branch Retinal Vein Occlusions: A Meta-Analysis.2019Ophtalmologica

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