Retinal specialists in Australia have welcomed the listing of a new pre-filled syringe to administer Eylea, manufactured by Bayer, on the Pharmaceutical Benefits Scheme (PBS) for treatment of four retinal conditions at a subsidised rate.1
The new pre-filled syringe provides clinicians with a further option to treat age related macular degeneration (AMD), diabetic macular oedema, retinal vein occlusion and subfoveal choroidal neovascularisation (CNV).
Professor Paul Mitchell, Director of the Centre for Vision Research at The Westmead Institute for Medical Research in Sydney, described the pre-filled syringe as “a major innovation” that would improve efficiency and safety for both practitioners and patients.
As well as reducing the risk of drug contamination and blinding endophthalmitis… the pre-filled syringe streamlines the intravitreal injection process
“This means all of the anti-VEGFs we now use are in pre-filled syringes. It saves time and is likely to reduce the likelihood of endophthalmitis, as was suggested in the French National Study.2 Bayer are to be applauded for its introduction. The particular device is pleasant to use and looks to be accurate in delivering the correct dose,” said Prof Mitchell.
Dr Simon Chen, Vision Eye Institute, said the availability of Eylea in a new sterilised prefilled syringe was positive news for retinal specialists in Australia.
“Prior to this, we had to transfer Eylea from a glass vial into a plastic syringe using a needle before injecting it into a patient’s eye.”
As well as reducing the risk of drug contamination and blinding endophthalmitis, he said the pre-filled syringe streamlines the intravitreal injection process.
“The use of a prefilled syringe can improve clinical efficiency as the doctor needs to perform fewer steps, which saves time for both the patient and the doctor. There are also benefits for the environment as fewer needles, less plastic and less wasted packaging are used for each injection.”
From 1 October 2020, PBS listing for Eylea administration via vial or pre-filled syringe also applies to the treatment of patients with CNV due to pathologic myopia (PM).1
PM is a severe form of myopia associated with an abnormal elongation of the eyeball and high myopia. CNV is a vision-threatening complication of PM and is characterised by the growth of pathologic new blood vessels from the choriocapillaris through a break in the Bruch’s membrane into the space under the retinal pigment epithelium or retina.3
Dr Chen said this new listing for treatment of CNV due to PM is expected by Bayer to benefit around 700 Australian patients each year.
“Myopic CNV (mCNV) is one of the most serious complications of pathologic myopia, often causing a progressive decline in central vision with a poor prognosis unless treated. Approximately 35% of patients with myopic CNV develop bilateral disease.
“Unlike CNV associated with AMD, myopic CNV is more often a disease of middle rather than older age. The average age that treatment typically begins for a myopic CNV patient is around 58 years. Unlike anti-VEGF therapy for patients with neovascular (wet) AMD who often need long-term regular injections over the course of many years, patients with myopic CNV typically need a much more limited number of injections, often only one to three injections given over the course of one to six months.”
Indeed, results of the Phase 3 MYRROR study of Eylea in mCNV demonstrate that a limited number of injections with Eylea given in the first eight weeks of treatment achieved clinically meaningful visual improvements and anatomic benefits that were maintained and extended through week 48.4
- Australian Government Department of Health. Pharmaceutical Benefits Schedule. Available at: www.pbs.gov.au/pbs/home;jsessionid=iuycz8ls6usw1l3aszoquvpxz. Accessed October 2020.
- Baudin F, Benzenine E, Mariet A, Bron A M, Daien V, Korobelnik JF, Quantin C, Creuzot-Garcher C. Association of Acute Endophthalmitis with Intravitreal Injections of Corticosteroids or Anti-Vascular Growth Factor Agents in a Nationwide Study in France. JAMA Ophthalmology. DOI: 10.1001/jamaophthalmol.2018.3939
- Neelam, K. et al. Choroidal neovascularization in pathological myopia. Progress in Retinal and Eye Research. 2012;31(5):495-525. doi: 10.1016/j.preteyeres.2012.04.001
- Ikuno, K. et al. Intravitreal Aflibercept Injection in Patients with Myopic Choroidal Neovascularization: The MYRROR Study. Ophthalmology. 2015;122(6):1220-7. doi:10.1016/j.ophtha.2015.01.025