AFLIBERCEPT
Background and Date of Approval
Aflibercept is an active ingredient used to treat eye conditions characterised by impaired vision due to abnormal blood vessel formation within the eye. These conditions include wet age-related macular degeneration and diabetic macular edema. Clinical studies demonstrate that this medication reduces the risk of vision loss and improves visual acuity in patients with these conditions. Most patients tolerate it well, and the injection procedure is relatively quick and minimally invasive. On November 18, 2011, the U.S. Food and Drug Administration (FDA) first authorised aflibercept for the treatment of neovascular age-related macular degeneration (AMD). The drug has subsequently received approval for the treatment of additional eye conditions, including diabetic macular edema and macular edema due to retinal vein occlusion.
Uses
Aflibercept is a drug used to treat various eye ailments such as neovascular age-related macular degeneration (AMD), diabetic macular edema, and macular edema after retinal vein occlusion. Neovascular AMD is when unusual blood vessels develop in the retina, leading to decreased eyesight. Meanwhile, diabetic macular edema is when fluid gathers in the macula, responsible for sharp and detailed vision in the retina's center.
How is it administered?
A healthcare provider will inject Aflibercept around the eye in a clinical setting. The dosage and frequency of infusions will vary depending on the patient's medical condition, age, weight, and other factors. A Person should not take a double dose to make up the second dose.
Side Effects
Aflibercept is generally well-tolerated but can cause side effects like all medications. Common side effects include eye pain, redness, itching, and temporary vision changes such as blurriness or seeing floaters. These side effects are generally mild and resolve on their own within a few days to a week. Serious side effects rarely occur, but they can occur. These include infections, inflammation, and bleeding in the eye, which can lead to vision loss. In rare cases, Aflibercept can also cause allergic reactions or blood clots.
Warnings
Aflibercept can cause endophthalmitis (an infection of the eye) and retinal detachment (separation of the retina from the underlying tissue). It may increase the risk of cardiovascular events such as heart attack or stroke in patients with a history of these conditions. This medication can cause a temporary increase in blood pressure in some patients. In long-term uses, this medication increases the risk of thromboembolic events such as deep vein thrombosis (DVT) and pulmonary embolism (PE). This medicine can also increase intraocular pressure (IOP), leading to glaucoma. Thrombotic microangiopathy (TMA) has been reported with the use of it. TMA is a rare but serious condition that can cause blood clots in small blood vessels throughout the body, leading to organ damage. Injection-related reactions, including inflammation, pain, and redness at the injection site, have been reported using intravitreal injections, including this medication.
Precautions
It is important to take several precautions when using Aflibercept. Individuals who are allergic to the drug or its components should not use it. If a patient has pre-existing heart conditions or kidney disease, close monitoring is necessary while taking this medication. It is also essential to avoid contact with individuals with infectious illnesses and immediately notify your healthcare provider if any signs of infection develop. Bleeding, anemia, and TMA are other side effects that should be reported to a doctor immediately. Patients should be regularly monitored for increased IOP, and if necessary, they should receive prompt treatment. Blood pressure is also monitored during treatment, and individuals with uncontrolled hypertension require careful observation throughout the treatment. Adjustments in the treatment plan may b necessary to manage side effects and ensure the best possible results.
Word of Advice
If you are currently being treated with aflibercept, notify your healthcare provider immediately if you experience any side effects or have concerns. Patients who are pregnant, planning to become pregnant, or breastfeeding should consult with their healthcare provider to discuss the potential risks and benefits of this treatment. Patients with diabetic retinopathy require close monitoring during treatment, as this medication may worsen the condition. If you experience eye pain, worsening redness of the eye, reduced or blurry vision, or increased sensitivity to light during treatment, inform your doctor promptly. Lifestyle modifications, including smoking cessation, maintenance of healthy weight, and adherence to a healthy diet, can improve overall health and reduce the risk of cancer-related complications. Emotional support from family, friends, or support groups can assist patients with cancer in managing their treatment challenges.
References
Katzung BG, Trevor AJ. Basic & Clinical Pharmacology, 14th Edition; 2018, 637-654 Goodman & Gilmanâs, The Pharmacological Basis of Therapeutics, 13th edition, 2018, 1113-114 Bayer AG, Electronic medicines compendium (EMC), [ Revised on Jan 2021] [ Accessed on 26th April 2023], https://www.medicines.org.uk/emc/files/pil.2879.pdf Regeneron Pharmaceuticals, Inc, US Food and Drug Administration, [ Revised on Nov 2011] [ Accessed on 26th April 2021], https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/125387lbl.pdf
Frequently Asked Questions
How often will I need to receive Aflibercept?
The frequency of Aflibercept will depend on the specific condition being treated and the patient's response to treatment. For wet AMD, patients typically receive an initial round of injections followed by regular maintenance injections every 4 to 8 weeks.
Will I still need to use my eyeglasses or contact lenses after receiving aflibercept treatment?
Yes, receiving Aflibercept will not correct refractive errors or cure any underlying eye conditions that may require corrective lenses. Patients should continue to use any prescribed eyeglasses or contact lenses as directed by their healthcare provider.
Can I receive local anesthesia before the Aflibercept?
Yes, local anesthesia may be used before the Aflibercept to help reduce pain and discomfort before the procedure. The anesthesia type will depend on the patient's needs and the healthcare provider's preferences.
Can Aflibercept cause eye infections?
While rare, there is a small risk of eye infections associated with Aflibercept. Patients should report any symptoms of eye infection, such as redness, swelling, pain, or discharge, to their healthcare provider immediately.
Can I take Aflibercept if I have high blood pressure?
Yes, you can still receive Aflibercept if you have high blood pressure. However, it is important to inform your healthcare provider of any existing medical conditions, including high blood pressure, before starting treatment with Aflibercept. This is because some patients may experience increased blood pressure as a side effect of the medication.
Can I take Aflibercept if I have a kidney problem?
If you have kidney problems, informing your healthcare provider before starting treatment with Aflibercept is important. While Aflibercept is primarily used to treat eye conditions and does not directly affect the kidneys, the medication is cleared from the body through the kidneys. Therefore caution may be needed in patients with impaired kidney function.