title: Aflibercept: newly approved for the treatment of macular edema following central retinal vein occlusion.
abstract: OBJECTIVE
  To review the pharmacology, efficacy, and safety data available for aflibercept and compare the drug to other therapeutic options for treatment of macular edema following central retinal vein occlusion (CRVO) to determine its likely role in therapy.
  
  
  METHODS
  A PubMed search using the terms aflibercept and VEGF trap-eye was conducted to identify initial literature sources. No timeframe was used for exclusion of older trials. All trials referenced were published between January 1995 and December 2012.
  
  
  METHODS
  Trials pertaining to oncologic use were excluded, as were studies conducted in animals and those written in a language other than English. Abstracts of the remaining trials were evaluated for determination of relevance to this review. Additional information sources were obtained via Internet and PubMed following a review of references.
  
  
  RESULTS
  While previous Phase 1, 2, and 3 trials for other indications (age-related macular degeneration and diabetic macular edema) have shown intravitreal injections of aflibercept to be safe and well tolerated in many patients, preliminary results from the ongoing COPERNICUS and GALILEO trials proved the efficacy of this medication in treating macular edema secondary to CRVO. Of the combined 358 patients studied in COPERNICUS and GALILEO, 56% and 60%, respectively, of the patients receiving aflibercept 2 mg monthly achieved at least a 15-letter improvement in best-corrected visual acuity (BCVA) from baseline over 6 months compared with just 12% and 22% in the control group (p < 0.01 for both). Additionally, in COPERNICUS and GALILEO, patients achieved a 21.3- and 14.7-letter improvement, respectively, in BCVA compared with placebo (p < 0.01 for both).
  
  
  CONCLUSIONS
  In September 2012, aflibercept became the second vascular endothelial growth factor (VEGF) inhibitor approved for treatment of macular edema secondary to CRVO. While efficacy and safety appear similar to other anti-VEGF treatments, the higher potency, binding affinity, and duration of action make aflibercept an appealing new option.
authors.affiliation: College of Pharmacy, Purdue University, Lafayette, IN, USA.
authors.forename: Kirk E
authors.initials: KE
authors.lastname: Evoy
authors.forename: Steven R
authors.initials: SR
authors.lastname: Abel
mesh_terms: D000818:Animals; D017277:Drug Approval; D006801:Humans; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000378:metabolism
chemical_list: D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor