Regeneron’s Eylea HD (aflibercept) injection 8 mg allows patients with wet age-related macular degeneration (wAMD), diabetic macular edema (DME), and diabetic retinopathy (DR) to receive less frequent treatment injections after their initial monthly doses than its predecessor, Eylea (aflibercept) injection 2 mg, while still experiencing similar visual gains and anatomic improvements with the same safety level as Eylea.
“We’ve continued to innovate in retinal disease care and evolved our proven anti–vascular endothelial growth factor (VEGF) therapy, Eylea, into Eylea HD,” says Kim Reed, OD, FAAO, executive director and head of global medical affairs in ophthalmology at Regeneron. Through feedback from retina specialists as well as patients and their caregivers, Regeneron identified and addressed an unmet need for therapeutic options that extend treatment durability and flexibility with Eylea HD, Dr. Reed says. Fewer injections can mean fewer visits to the doctor’s office and more time for other things. In turn, retina specialists have increased availability to see and treat more patients.
Jordana G. Fein, MD, MS, an assistant clinical professor of ophthalmology at Georgetown University School of Medicine and a retina specialist at The Retina Group of Washington in Fairfax, Virginia, who participated in an Eylea HD clinical trial, says she prescribes the medication to patients who were on Eylea and other anti-VEGF medications who wanted to extend the interval between treatments, as well as to treatment-naive patients. “I’ve been pleased with the efficacy and safety results thus far, and look forward to offering it to additional patients in the future,” she says.
The main difference between Eylea and Eylea HD is that Eylea HD is a higher-dose, longer-acting formulation of Eylea. “Eylea HD delivers a four-fold higher molar concentration of aflibercept compared to Eylea, so I don’t have to inject patients as often,” says Dr. Fein. After their initial monthly doses, some wAMD and DME patients receiving Eylea HD may be able to extend to 4 months between treatments.
Some wAMD and DME patients have had significant vision improvement, as evidenced by being able to see more letters on an eye chart, as well as noticeable improvements on retinal imaging.1 Eylea HD helped DME patients achieve an average of 20/40 vision in 1 year, which is a requirement for driving in most states.2,3 Some individuals with DR who received Eylea HD saw a reduction in their disease severity in a clinical study after 1 year.1
How It Works
The active ingredient in Eylea HD, aflibercept, blocks VEGF-A and placental growth factor, halting abnormal growth of new blood vessels that may lead to vision loss, Dr. Reed says. Eylea HD’s novel formulation delivers 4 times the dose of Eylea in a single injection and has been carefully engineered to maintain extended tolerability, solubility, and stability, she adds. Eylea HD has been shown to extend aflibercept’s durability while reducing treatment injection frequency to every 12 or 16 weeks (after 3 monthly starter doses) in more than 75% of patients.4 Eylea HD is indicated for patients with wAMD, DME, or DR who are newly diagnosed or already on another anti-VEGF treatment for their disease.
“Since the FDA’s approval of Eylea HD, I have had a very positive experience with my patients who have started on this therapy,” Dr. Fein says. She adds that some patients still receive Eylea injections for a variety of reasons, including those who have commercial insurance plans that haven’t approved Eylea HD on their formulary list, and a minority of patients who aren’t able to extend their treatment regimens. In addition, the new drug is not approved for patients with retinal vein occlusion.
A few common adverse reactions that have been reported with the use of Eylea HD include eye pain and irritation, blurred vision, and increased intraocular pressure. Additional long-term data and subgroup analyses with Eylea HD are expected in the coming months. RP
References
- EYLEA HD. Prescribing information. Regeneron Pharmaceuticals, Inc; 2023.
- Data on file with Regeneron.
- Steinkuller PG. Legal vision requirements for drivers in the United States. Virtual Mentor. 2010;12(12):938-940. doi:10.1001/virtualmentor.2010.12.12.hlaw1-1012
- Brown DM, Boyer DS, Do DV, et al. Intravitreal aflibercept 8 mg in diabetic macular oedema (PHOTON): 48-week results from a randomised, double-masked, non-inferiority, phase 2/3 trial. 2024;403(10432):1153-1163. doi:10.1016/S0140-6736(23)02577-1
