Neovascular Age-Related Macular Degeneration Treatments

NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATMENTS
Generic Brand Strength Form Adult Dose
VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) INHIBITORS
brolucizumab-dbll Beovu 6mg/0.05mL soln for intravitreal inj 6mg (0.05mL) once monthly (approx. 25–31 days) for the 1st 3 doses, followed by 6mg (0.05mL) once every 8–12wks
pegaptanib sodium Macugen 0.3mg per prefilled syringe soln for intravitreal inj 0.3mg once every 6wks
ranibizumab Lucentis 6mg/mL (0.3mg), 10mg/mL (0.5mg) soln for intravitreal inj 0.5mg (0.05mL of 10mg/mL) once a month (approx. 28 days); or 3 monthly doses followed by less frequent dosing (less effective); or 0.5mg every 3mos after 4 monthly doses (less effective). Monitor regularly.
Byooviz1 10mg/mL (0.5mg) soln for intravitreal inj
Cimerli1 6mg/mL (0.3mg), 10mg/mL (0.5mg) soln for intravitreal inj
Susvimo1,2 100mg/mL

soln for intravitreal implant or intravitreal inj

2mg (0.02mL of 100mg/mL) continuously delivered via implant. Refill every 24wks (approx. 6mos). Supplemental treatment: 0.5mg (0.05mL of 10mg/mL) intravitreal inj into the affected eye while implant is in place, as clinically needed.
VEGF INHIBITOR + ANGIOPOIETIN-2 (ANG-2) INHIBITOR
faricimab-svoa Vabysmo 120mg/mL soln for intravitreal inj 6mg (0.05mL) once every 4wks (approx. every 28 ± 7 days, monthly) for the 1st 4 doses, followed by optical coherence tomography and visual acuity evaluations 8 and 12wks later to determine whether to give a 6mg (0.05mL) dose on one of the following 3 regimens: (1) Weeks 28 and 44; (2) Weeks 24, 36 and 48; or (3) Weeks 20, 28, 36 and 44.
VEGF INHIBITOR + HUMAN IgG1
aflibercept Eylea 2mg/0.05mL soln for intravitreal inj 2mg (0.05mL) once every 4wks (approx. 28 days, monthly) for the 1st 12wks (3mos), followed by 2mg (0.05mL) once every 8wks (2mos); some may need the monthly dosing after the 1st 3mos. May also treat with 1 dose every 12wks after one year of successful therapy (not as effective); assess regularly.
PHOTOSENSITIZER
verteporfin Visudyne3 15mg per vial pwd for IV infusion after reconstitution and dilution Infuse over 10mins at a rate of 3mL/min. Usual dose: 6mg/m2. After infusion, the second step is activation of verteporfin with light from a nonthermal diode laser. Reevaluate every 3mos and if choroidal neovascular leakage is detected on fluorescein angiography, therapy should be repeated.
NOTES

1 Biosimilar to Lucentis.

2 In patients who have previously responded to at least 2 intravitreal injections of a VEGF inhibitor.

3 Consider for wet AMD patients with persistent intraocular fluid leakage, including anti-VEGF nonresponders.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Created 9/2022