Aflibercept 8 mg versus Faricimab Treat-and-Extend for Diabetic Macular Edema or Neovascular Age-Related Macular Degeneration: A Bayesian Fixed-Effect Network Meta-analysis of Clinical Trials
Bibliographic record
Abstract
INTRODUCTION: Reducing intravitreal injection frequency while maintaining efficacy is a critical goal in alleviating the burden associated with anti-vascular endothelial growth factor (VEGF) therapy in patients with diabetic macular edema (DME) or neovascular age-related macular degeneration (nAMD). In clinical trials, aflibercept 8 mg and faricimab 6 mg administered at extended dosing intervals have demonstrated similar efficacy compared with aflibercept 2 mg, but with fewer injections. This network meta-analysis (NMA) indirectly compared numbers of injections and efficacy between aflibercept 8 mg and faricimab 6 mg administered according to a treat-and-extend (T&E)-based regimen in patients with DME or nAMD. METHODS: A systematic literature review was conducted on 10 January 2025, to identify randomized controlled trials of aflibercept 8 mg or faricimab T&E with observation periods of approximately 2 years. Outcomes included number of injections, absolute change from baseline in best-corrected visual acuity (BCVA), and absolute and percentage change from baseline in central subfield thickness (CST). NMAs were performed with Bayesian statistical models. Injection numbers were adjusted to 104 weeks to account for differences in trial observation periods. RESULTS: The NMA included 2-year data from six trials: PHOTON, YOSEMITE, and RHINE (DME); and PULSAR, TENAYA, and LUCERNE (nAMD). Treatment with aflibercept 8 mg was associated with significantly fewer injections compared with faricimab T&E in patients with DME (mean difference -3.62 [95% credible interval -4.22, -3.02]) or nAMD (-1.47 [-1.90, -1.05]). Mean changes from baseline in BCVA (absolute) or CST (absolute and percentage) did not differ significantly between the two treatments. CONCLUSION: This NMA indicated that aflibercept 8 mg required significantly fewer injections while maintaining similar efficacy over 2 years of treatment compared with faricimab T&E in patients with DME or nAMD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".