EYLEA 8 mg: Better, Faster, and Longer Drying

“Does EYLEA (aflibercept) 8 mg provide better drying where it matters?” This was the question discussed by retina specialist Professor Paolo Lanzetta of the University of Udine, Italy, at the Bayer symposium at 2025’s Controversies in Ophthalmology (COPHy) meeting (Seville, Spain, April 4-5).

From the published research, the answer is quite positive. In patients with neovascular age-related macular degeneration (nAMD), Lanzetta pointed to a secondary endpoint of the PULSAR study1 – a phase III, randomised, three-group, double-masked, non-inferiority, 96-week trial conducted across 223 sites worldwide – to show that aflibercept 8 mg showed superior drying to aflibercept 2 mg at week 16 in patients with nAMD. “The proportion of patients without retinal fluid in the central subfield at week 16 was definitely better in patients treated with 8 mg than 2 mg, and remained true at week 48,” said Lanzetta. (Figure 1) Patients with nAMD also reached fluid-free status with EYLEA 8 mg in a faster time compared with aflibercept 2 mg.

In patients with diabetic macular edema (DME), he highlighted a post-hoc analysis of the PHOTON study2– a randomised, double-masked, non-inferiority, phase II/III trial performed at 138 hospitals and specialty retina clinics in seven countries – to show that aflibercept 8 mg also provided a better drying effect versus the 2 mg dosage, observed as a secondary outcome.3 In this case EYLEA 8 mg demonstrated more resilient fluid control than aflibercept 2 mg even in eyes with the most severe disease in patients with DME (Figure 2). Further. a greater proportion of patients with DME achieved a fluid-free foveal centre after switching from aflibercept 2 mg to EYLEA 8 mg, resulting in greater reductions in central retina thickness (CRT) when compared with aflibercept 2 mg in DME patients who require more frequent dosing.

In terms of EYLEA 8 mg providing extended treatment intervals, Lanzetta noted that extensions to the PULSAR and PHOTON studies revealed that ~4 in 10 patients with nAMD achieved a last assigned treatment interval of ≥5 months at week 156, and ~5 in 10 patients with DME achieved a last assigned treatment interval of ≥5 months at week 156. At the same follow-up point, both PULSAR and PHOTON also showed that meaningful vision gains were sustained in patients with nAMD and DME through Year 3.

Moving from clinical research to the impact of EYLEA 8 mg in the real world, Lanzetta provided case studies of two of his own patients, one treatment-naïve with nAMD OS, the other treatment-naïve with DME OU.

One month after the first injection of EYLEA 8 mg, Lanzetta’s 71-year-old male nAMD patient, who had an initial best-corrected visual acuity (BCVA) of 20/63, “showed an improvement in BCVA of 10 letters (Snellen), the pattern dystrophy (PD) had gone, and the intraretinal fluid had been completely reabsorbed.” Lanzetta went on, “This is not something we have routinely seen before.” Two months after the patient’s fourth injection of EYLEA 8 mg, “the situation remained very stable,” with BCVA of 20/32. Following the loading doses, the patient was able to be extended to Q16 with EYLEA 8 mg (Figure 3).

Similarly, Lanzetta’s treatment-naïve 60-year-old female DME patient demonstrated meaningful vision gains (+10 ETDRS letters) and a rapid reduction in fluid (−128μm) through the loading phase with EYLEA 8 mg (Figure 4).

Speaking later to The Ophthalmologist, Lanzetta explained, “We have now more than 30 patients being treated with aflibercept 8 mg. Some of them were naïve; some were switched from previous therapies. We looked very closely at the early effects; patients were monitored from one day after the injection, then at 7 days, 14 days, 30 days, 60 days, and then 90 days, which means after the loading phases with three consecutive monthly injections.”

Lanzetta and his team have made some “very interesting” observations in patients, he continued. “In regard to the total improvement in retinal thickness, which we saw in 90 days, 30 percent of that improvement was already visible on day one. One week after the first injection, the improvement was 70 percent. Basically, 90 percent of the total fluid was resolved by one month, that is, after a single injection. This also corresponded to a very early improvement in visual acuity.”

Lanzetta added, “In terms of daily life, those patients with relatively good vision at baseline after the treatment talked about improvements in reading capacity and driving their cars. So, there can be an immediate effect. And we know from the trials that this early improvement in visual acuity and this early drying effect translates in the long term.”

In terms of the clinical studies and what he is seeing in practice, then, Lanzetta concluded: “The answer is yes – EYLEA 8 mg does provide a better, faster, and longer drying effect.”

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