PHARMACOKINETIC RATIONALE FOR DOSING EVERY 2 WEEKS VERSUS 4 WEEKS WITH INTRAVITREAL RANIBIZUMAB, BEVACIZUMAB, AND AFLIBERCEPT (VASCULAR ENDOTHELIAL GROWTH FACTOR TRAP-EYE)

Abstract

The theoretical increase in trough binding levels when anti-VEGF drugs are dosed every 2 weeks most likely explains the clinical benefit observed in patients who received biweekly injections after their poor response to monthly therapy. The short-term use of biweekly dosing may be an attractive treatment option for those eyes that show a treatment response within 2 weeks of an injection, but rebound with increased macular fluid after a month. In the future, VTE should provide higher trough levels of anti-VEGF binding activity and eliminate the need for biweekly dosing in those eyes with VEGF-mediated exudation that appear unresponsive to monthly ranibizumab or bevacizumab.