The SALWEEN study, presented at the 2024 Asia-Pacific Vitreo-retina Society (APVRS) conference in Singapore, marks a significant step forward in precision medicine for ophthalmology.
As healthcare moves toward individualised treatments, the SALWEEN study highlights how personalised approaches are reshaping the management of Polypoidal Choroidal Vasculopathy (PCV), a prevalent and challenging subtype of neovascular age-related macular degeneration (nAMD) in Asian populations.
PCV primarily impacts the blood vessels in the layer beneath the retina, leading to damage in the cells responsible for vision. This can cause serious vision impairment or even vision loss if left untreated.
Personalised Dosing in Tailored Eye Care
Vabysmo® (faricimab) by Roche is the first bispecific antibody approved for ocular use. Designed to inhibit both angiopoietin-2 (Ang-2) and vascular endothelial growth factor-A (VEGF-A), Vabysmo targets two key pathways involved in retinal disease.
The SALWEEN study, which is being conducted across multiple countries in Asia, including China, Japan and South Korea, involves 135 patients aged 50 years and older.
Patients in the SALWEEN study begin with four loading doses of Vabysmo 6.0 mg over 12 weeks to stabilise the condition. This is followed by a personalised schedule based on their disease activity. Doses are given every 8, 12, or 16 weeks. From weeks 44 to 104, treatment intervals can extend to as much as 20 weeks, reducing the treatment burden – a common barrier in retinal care.
The primary endpoint is the change from baseline best-corrected visual acuity (BCVA) averaged over weeks 40-48.
This flexibility offers a dual benefit: maintaining or improving visual outcomes while aligning treatment intensity with each patient’s specific needs, avoiding over- or under-treatment.
Clinical Evidence: A Leap Forward in Outcomes
The interim results from SALWEEN shows promising results for PCV. Patients treated with Vabysmo showed an average improvement of +7.8 letters in their vision test at 16 weeks. Patients also experienced a substantial reduction in retinal swelling, with 80% of patients having no fluid in the retina. In addition, 51% of patients with polypoidal lesions saw complete disappearance of these abnormal blood vessels completely disappear.
“PCV has historically been more challenging to treat, with outcomes that are less predictable compared to typical neovascular age-related macular degeneration. Given that PCV accounts for about half of all nAMD cases in Asian populations, and up to 20% in Caucasian populations, the SALWEEN trial is a significant step forward,” said Professor Gemmy Cheung, Head of Retina Research at SERI and Head of the Medical Retina Department at the Singapore National Eye Centre (SNEC).
For patients with polypoidal lesions, 51% saw complete resolution—a milestone in addressing one of the most challenging aspects of PCV.
These outcomes highlight how a personalised regimen can maximise therapeutic benefits while minimising treatment burden. For healthcare professionals, this represents a paradigm shift, enabling data-driven, patient-centred care.
Precision Medicine: Implications for Clinical Practice
The shift toward precision medicine in retinal care aligns with broader healthcare trends. By tailoring interventions based on disease progression and patient-specific factors, clinicians can:
- Optimise Outcomes: Achieve better visual and anatomical results through targeted treatments.
- Reduce Burden: Minimize clinic visits and invasive procedures for patients.
- Enhance Cost-Effectiveness: Allocate healthcare resources more efficiently by reducing unnecessary treatments.
For a condition like PCV, which disproportionately affects Asian populations, these benefits are particularly impactful. The SALWEEN study’s Asia-focused design ensures that its findings are directly applicable to the region’s unique demographic and clinical needs.
Looking Ahead: The Future of Retinal Care
The insights from SALWEEN not only advance our understanding of PCV management but also set a new standard for how retinal diseases are treated—through science that is as precise as it is compassionate.
The recent TENAYA and LUCERNE trials also shows how personalised treat-and-extend dosing can deliver robust patient outcomes. By tailoring injection intervals based on AMD disease activity, these protocols have demonstrated that nearly 80% of patients can extend treatment intervals to every 12 weeks or more by the second year. This reduces the burden of frequent office visits without compromising visual gains, a significant quality-of-life improvement for patients
For further details on the SALWEEN study and its interim findings, visit Roche’s dedicated ophthalmology resources or the APVRS 2024 conference proceedings.
