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Treat-And-Extend Regimens with Anti-Vegf Agents in Retinal Diseases

Lookup NU author(s): James Talks

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Abstract

Copyright © by Ophthalmic Communications Society, Inc.Purpose: A review of treat-and-extend regimens (TERs) with intravitreal anti-vascular endothelial growth factor agents in retinal diseases. Methods: There is a lack of consensus on the definition and optimal application of TER in clinical practice. This article describes the supporting evidence and subsequent development of a generic algorithm for TER dosing with anti-vascular endothelial growth factor agents, considering factors such as criteria for extension. Results: A TER algorithm was developed; TER is defined as an individualized proactive dosing regimen usually initiated by monthly injections until a maximal clinical response is observed (frequently determined by optical coherence tomography), followed by increasing intervals between injections (and evaluations) depending on disease activity. The TER regimen has emerged as an effective approach to tailoring the dosing regimen and for reducing treatment burden (visits and injections) compared with fixed monthly dosing or monthly visits with optical coherence tomography-guided regimens (as-needed or pro re nata). It is also considered a suitable approach in many retinal diseases managed with intravitreal anti-vascular endothelial growth factor therapy, given that all eyes differ in the need for repeat injections. Conclusion: It is hoped that this practical review and TER algorithm will be of benefit to health care professionals interested in the management of retinal diseases.


Publication metadata

Author(s): Freund KB, Korobelnik J-F, Devenyi R, Framme C, Galic J, Herbert E, Hoerauf H, Lanzetta P, Michels S, Mitchell P, Mones J, Regillo C, Tadayoni R, Talks J, Wolf S

Publication type: Review

Publication status: Published

Journal: Retina

Year: 2015

Volume: 35

Issue: 8

Pages: 1489-1506

Print publication date: 01/08/2015

Acceptance date: 01/01/1900

ISSN (print): 0275-004X

ISSN (electronic): 1539-2864

Publisher: Lippincott Williams and Wilkins

URL: https://doi.org/10.1097/IAE.0000000000000627

DOI: 10.1097/IAE.0000000000000627


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