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Macular DegenerationMarch 2024

What the PULSAR Trial Found — High-Dose Aflibercept for Wet Macular Degeneration

PULSAR tested whether a higher dose of aflibercept (8 mg vs. the standard 2 mg) lets patients with wet age-related macular degeneration stretch their eye injections farther apart. Across 1,011 adults, vision gains were equal — but ~80% of high-dose patients only needed an injection every 12 weeks or longer.

What the trial was testing

The PULSAR enrolled 1,011 patients with macular degeneration. The study was sponsored by Bayer and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

~80% of patients on high-dose aflibercept stretched injections to every 12 weeks or longer.

The Lancet · 2024 · NCT04423718

These findings — that on high-dose aflibercept stretched injections to every 12 weeks or longer at 48 weeks — were published in the The Lancet and represent the headline result of the study.

Researchers tracked outcomes across 1,011 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with macular degeneration, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Aflibercept 8 mg (Eylea HD) is FDA-approved for wet macular degeneration and available now. If you're already getting Eylea, ask your retina specialist whether the higher-dose version could let you cut your injection visits roughly in half. Vision outcomes are the same; the win is fewer trips to the office.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.