Expert: Recombinant fusion protein combining VEGF-binding domains from VEGFR1 and VEGFR2 fused to IgG1 Fc. Binds VEGF-A (all isoforms), VEGF-B, and placental growth factor (PlGF). Intravitreal injection. Higher VEGF-binding affinity than ranibizumab.

Everyday: A decoy receptor that soaks up VEGF — the protein that makes abnormal blood vessels grow in the eye. By trapping VEGF before it can signal, it stops the leaky blood vessels that cause vision loss. Like a sponge that absorbs the signal before it reaches its target.

Targets: ["VEGF-A","VEGF-B","PlGF"]

Primary EP: [{"id":"view1-vision","name":"Maintained vision at Week 52 (lost <15 letters)","type":"PRIMARY","unit":"%","results":[{"notes":"Non-inferior to ranibizumab. Difference +0.6% (95.1% CI -3.2 to 4.4)","v

Efficacy: VIEW 1 met primary endpoint: EYLEA 2mg Q8W was non-inferior to ranibizumab Q4W (94% vs 94% maintained vision). Q8W dosing enabled less frequent injections with equivalent efficacy. Mean BCVA gain: +7.9 letters (EYLEA Q8W) vs +8.1 letters (ranibizumab Q4W).

Safety: VIEW 1 (n=1217): Injection-procedure-related AEs similar across arms. Conjunctival hemorrhage 25% vs 28%, eye pain 9% vs 9%, cataract 7% vs 7%, IOP increased 5% vs 7%. Endophthalmitis <0.1% per inject

Primary EP: [{"id":"view2-vision","name":"Maintained vision at Week 52 (lost <15 letters)","type":"PRIMARY","unit":"%","results":[{"notes":"Non-inferior to ranibizumab. 95.6% vs 94.4%","value":95,"arm_id":"eylea-

Efficacy: VIEW 2 confirmed VIEW 1: EYLEA Q8W (95.6%) was non-inferior to ranibizumab Q4W (94.4%) for vision maintenance. Pooled VIEW 1+2 analysis led to FDA approval in 2011.

Safety: VIEW 2 (n=1240): Similar safety profile to VIEW 1. Conjunctival hemorrhage, eye pain, and IOP increase most common. Endophthalmitis <0.1%.

EYLEA 2mg Biosimilar Competition Impact 2026 (ongoing)

DECLINING — biosimilar threat is the key bear case. EYLEA 2mg facing multiple biosimilar approvals starting 2025. US net sales declining as patients transition to EYLEA HD (8mg). Bayer holds ex-US license. EYLEA franchise (2mg + HD combined) still ~$5.5B+ US, but trajectory is down for 2mg formulation.

{"keyRisks":[{"category":"Endophthalmitis","description":"Serious intraocular infection. Risk with any intravitreal injection. Proper aseptic technique required.","incidenceRate":"0.1% per injection"},{"category":"Retinal detachment","description":"Rare but serious complication of intravitreal injection procedure.","incidenceRate":"<0.1%"},{"category":"IOP increase","description":"Transient intraocular pressure elevation within 60 minutes of injection. Monitor and manage.","incidenceRate":"5-7%"},{"category":"Conjunctival hemorrhage","description":"Most common AE — subconjunctival bleeding at injection site. Self-limiting.","incidenceRate":"25-28%"},{"category":"Eye pain","description":"Pain at injection site, typically mild and transient.","incidenceRate":"9%"},{"category":"Arterial thromboembolic events","description":"Anti-VEGF class risk. Stroke, MI reported at low rates. Similar across VEGF inhibitors.","incidenceRate":"1-2%"}],"monitoring":["IOP check post-injection","Dilated fundus exam before each injection","Instruct patient to report eye pain, vision loss, floaters immediately"],"classWarnings":["Anti-VEGF: theoretical risk of arterial thromboembolic events","Intravitreal injection procedure carries endophthalmitis/retinal detachment risk"],"hasBoxedWarning":false}