Aflibercept 8 mg for diabetic macular edema and neovascular age-related macular degeneration: an italian expert consensus paper.

PURPOSE: To provide consensus recommendations on the clinical use of aflibercept 8 mg in managing neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) in the real-world setting. METHODS: A modified Delphi study was undertaken, involving ophthalmologists from specialized centers in Italy, to gauge consensus on statements related to the use of aflibercept 8 mg in nAMD and DME. Two initial rounds of online surveys were conducted, followed by 2 workshops to assess the clinical feasibility of selected statements and identify the behavioral drivers and barriers to their adoption in practice. Consensus was defined as ≥ 75% agreement ('strongly agree' or 'somewhat agree'). RESULTS: Consensus was reached for 30 initial statements, following refinement and discussion. Of these, 12 statements were analyzed and discussed at the behavioral workshop. Statements covered clinical differentiation of aflibercept 2 mg and 8 mg, treatment initiation in aflibercept-naïve patients, switching to aflibercept 8 mg, optimal aflibercept 8 mg maintenance, and safety considerations. There was expert group consensus that aflibercept 8 mg represents a viable treatment option with an extended injection interval for patients with nAMD or DME, with the possibility of improving treatment adherence, and therefore outcomes. Experts also discussed practical considerations in Italy and offered evidence-based guidance. CONCLUSION: Experts agreed that aflibercept 8 mg is a treatment option for both nAMD and DME with the potential to improve treatment adherence. Although real-world data are limited, experts offered guidance on the management of nAMD and DME in the context of aflibercept 8 mg.