Eylea HD Means Longer Dosing Intervals, Real-World Studies Show | ASRS 2025

Results from the PHOTON study provided the key evidence that 8-milligram doses of aflibercept, sold under the brand name Eylea HD, could be given longer dosing intervals and remain safe and effective.

Now researchers are beginning to explore how those clinical trials and use of Eylea HD are playing out in clinical practice.

Michael Javaheri, M.D.

At the American Society of Retina Specialists meeting yesterday, Michael Javaheri, M.D., of the Retina Specialists of Beverly Hills, presented the results of real-world treatment patterns of Eylea HD among patients with diabetic macular edema. The FDA has approved Eylea HD as a treatment for diabetic macular edema along with neovascular (wet) age-related macular degeneration and diabetic retinopathy.

Javaheri and his colleagues tapped into the American Academy of Ophthalmology’s Intelligent Research in Sight (IRIS) and Vestrum Health Retina databases to compare dosing intervals before and after patients switched from other anti-vascular endothelial growth factor (VEGF) inhibitors to Eylea HD. Approximately three-quarters of the patients who switched to Eylea HD had been treated with the 2-milligram dose of aflibercept, sold as Eylea. A sizable minority (13% in the IRIS database and 8% in the Vestrum database) switched from Vabysmo (faricimab). The study included 9,109 treated eyes from the IRIS database and 3,722 eyes from the Vestrum database. The patients in the two databases were similar: an average age of 66, slightly more than half (56%) were men, and most (90%) had diabetic macular edema that affected both eyes.

Javaheri and his colleagues found that the dosing interval was, on average, 16 days longer in the IRIS database and 19 days longer in the Vestrum after patients switched to Eylea HD. When the preswitch dosing interval was four to less than six weeks, the dosing interval was 20 days longer among the eyes in the IRIS database and 24 days longer among those in the Vestrum database. When the preswitch dosing interval was longer — six to eight weeks or less — the dosing interval among the eyes in the IRIS database was 13 days longer and 16 days longer among those in the Vestrum database.

They conclude in the abstract of their presentation that “early real-world experience” suggests dosing intervals could be extended by two or more weeks among eyes with diabetic macular edema that had been consistently treated with an anti-VEGF treatment prior to switching to Eylea HD.

The same authors used the same databases to conduct a similar real-world study of dosing interval patterns among patients with neovascular (wet) age-related macular degeneration. They arrived at the same conclusion: switching to Eylea HD meant longer dosing intervals, suggesting that dosing intervals could be extended by two weeks or more for those who had been treated with other kinds of anti-VEGF injections. As in the study of patients with diabetic macular edema, most (approximately 71%) of the patients had been treated with the 2-milligram dose of aflibercept before switching to Eylea HD, and a sizable minority (18%) had been treated with Vabysmo.