Vision-Related Quality of Life in Patients with Diabetic Macular Edema Treated with Intravitreal Aflibercept: The AQUA Study.


Serval ID
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Vision-Related Quality of Life in Patients with Diabetic Macular Edema Treated with Intravitreal Aflibercept: The AQUA Study.
Ophthalmology. Retina
Garweg J.G., Stefanickova J., Hoyng C., Schmelter T., Niesen T., Sowade O., Sivaprasad S.
Working group(s)
AQUA Investigators
Adan A., Alexik M., Ali F., Amaro M., Balciuniene V.J., Bandello F.M., Arias Barquet L., Beck A., Bell K., Boscia F., Bures A., Carneiro Â., Chow D.R., Cimbalas A., Dahlke C., Deepali V., Dickinson J.D., Dollin M., Eandi C., Emmerich K.H., Feltgen N., Pereira Figueira J., Findl O., Gajdošová M., Gale R.P., John Galic I., Garweg J., Gasser-Steiner V., Giunta M., Gonder J.R., Grzybowski A., Hamouz J., Hattenbach L.O., Holz F.G., Jesia H., Kaluzny J., Kerenyi A., Kertes P.J., Koch F., Kodjikan L., Lederer D.E., Liehneova I., Lorenz K., Lotery A.J., McKibbin M., Menon G.V., Michalewska Z., Midena E., Nicolo M., Papp A., Pavlovičová G., Peiretti E., Vaz-Pereira S., Perri P., Petropoulos I., Queguiner F., Raczynska K., Sararols-Ramsay L., Rękas M., Ricci F., Romanowska-Dixon B., Sachs H.G., Mohand-Said S., Sandner D., Schmidt-Erfurth U., Sekundo W., Seres A., Sivaprasad S., Souied E., Castro de Sousa J., Stankiewicz A., Štefaničková J., Struhárová K., Studnicka J., Cervera Taulet E., Taylor S., Teper S., Vajas A., Cava Valenciano C., Varsányi B., Viola F., Virgili G., Wagenfeld L., Walters G., Wiedemann P., Zarnowski T.
2468-6530 (Electronic)
Publication state
Issued date
Publication types: Clinical Trial, Phase IV ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
To examine vision-related quality of life in patients with diabetic macular edema (DME) treated with intravitreal aflibercept (EYLEA, Regeneron Pharmaceuticals, Inc, Tarrytown, NY).
AQUA was a multicenter, open-label, single-arm, phase 4 study.
Adults 18 years of age or older with type 1 or 2 diabetes mellitus and DME.
Patients received intravitreal aflibercept 2 mg every 8 weeks for 52 weeks, after 5 initial doses every 4 weeks.
The primary outcome was the change in 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) total score from baseline to week 52. Secondary outcomes included the change in NEI VFQ-25 near and distant activities subscale scores, best-corrected visual acuity (BCVA; Early Treatment Diabetic Retinopathy Study [ETDRS] letters), and central retinal thickness (CRT) from baseline to week 52. Change in NEI VFQ-25 score at week 52 for better-seeing eyes (BSEs) and worse-seeing eyes (WSEs) also was evaluated.
A total of 553 patients comprised the full analysis set, and 560 patients comprised the safety analysis set. At baseline, the mean NEI VFQ-25 total score was 70.12, mean BCVA was 61.5 ETDRS letters, and mean CRT was 464.81 μm. A mean of 8.8 injections were administered over 52 weeks. At week 52, the mean improvement from baseline in the NEI VFQ-25 total score was +6.11 (standard deviation [SD], 11.46); the corresponding improvements in near and distant activities were +11.37 (SD, 18.01) and +7.33 (SD, 17.32), respectively. Similarly, improvements in patients whose BSE and WSE were treated were 7.74 (SD, 13.59) and 5.48 (SD, 9.70), respectively. At week 52, mean change in BCVA was +10.0 ETDRS letters (SD, 8.0 ETDRS letters), and mean change in CRT was -175.38 μm (SD, 132.62 μm). Overall, 53.6% of patients reported treatment-emergent adverse events (TEAEs), of whom 26.8% experienced an ocular TEAE in the study eye. The most common serious ocular TEAE was endophthalmitis (0.5% [n = 3]). Five deaths (0.9%) were reported, but were not considered treatment related.
Intravitreal aflibercept was associated with clinically meaningful improvements in NEI VFQ-25 total score over 52 weeks in patients with DME; these were even more pronounced for near than for distant activities. Adverse events were consistent with the known safety profile of intravitreal aflibercept.
Aged, Angiogenesis Inhibitors/therapeutic use, Diabetes Mellitus, Type 1/complications, Diabetes Mellitus, Type 2/complications, Diabetic Retinopathy/diagnosis, Diabetic Retinopathy/drug therapy, Diabetic Retinopathy/psychology, Female, Humans, Intravitreal Injections, Macular Edema/diagnosis, Macular Edema/drug therapy, Macular Edema/psychology, Male, Middle Aged, Quality of Life/psychology, Receptors, Vascular Endothelial Growth Factor/therapeutic use, Recombinant Fusion Proteins/therapeutic use, Sickness Impact Profile, Single-Blind Method, Surveys and Questionnaires, Tomography, Optical Coherence, Vascular Endothelial Growth Factor A/antagonists & inhibitors, Vision, Ocular/physiology, Visual Acuity/physiology
Open Access
Create date
12/03/2021 19:37
Last modification date
26/03/2021 6:35
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