Comparison of Time to Retreatment and Visual Function Between Ranibizumab and Aflibercept in Age-Related Macular Degeneration.

Abstract

PURPOSE:

To compare time to retreatment and visual function between patients with treatment-naïve neovascular age-related macular degeneration (AMD) treated with either intravitreal ranibizumab (IVR) or intravitreal aflibercept (IVA) in routine clinical practice.

DESIGN:

Retrospective, interventional comparative case series.

PARTICIPANTS:

A total of 200 eyes of 197 patients with neovascular AMD.

METHODS:

A total of 99 patients in the IVR group and 101 patients in the IVA group who met the inclusion criteria with 12 months of follow-up were included in the present study. All patients received 3 consecutive monthly injections of 0.5 mg/0.05 mL ranibizumab or 2.0 mg/0.05 mL aflibercept as loading doses. Retreatment was allowed if evidence of clinical deterioration or the presence of intraretinal edema or subretinal fluid on spectral-domain optical coherence tomography examination performed at the 1-month follow-up was noted. The time to retreatment after the third injection during the loading phase to the first recurrence during the maintenance phase was compared between treatments using the Kaplan-Meier analysis. Functional and anatomic outcomes were also compared between the IVR and IVA groups.

RESULTS:

The median time to retreatment after the last induction dose was 5 months in both groups. The proportion of IVR patients who required injection retreatment was not significantly higher than that of IVA patients (67.7% and 63.4%, respectively, at the 12-month follow up; log-rank test, P = .554). In both groups, significant improvements in postoperative best-corrected visual acuity (BCVA) compared with preoperative visual acuity was observed over the 12-month follow-up period (P < .05 for both). Central foveal thickness (CFT) decreased from the baseline values in both groups during the follow-up period (P < .001 for both). Although there was a trend toward greater BCVA improvements in the IVA group, no significant differences in BCVA or CFT were observed between the treatment groups.

CONCLUSIONS:

Both IVR and IVA were well tolerated and demonstrated efficacy in improving the visual acuity in treatment-naïve patients with AMD. Despite a trend toward greater BCVA improvements in the IVA group, a similar injection burden was observed following the loading phases of both ranibizumab and aflibercept.

• Authors: Maiko Inoue, Shin Yamane, Shimpei Sato, Kentaro Sakamaki, Akira Arakawa, Kazuaki Kadonosono
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 169 Pg. 95-103 (Sep 2016) ISSN: 1879-1891 [Electronic] United States
• PMID: 27320059 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Recombinant Fusion Proteins
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• aflibercept
• Receptors, Vascular Endothelial Growth Factor
• Ranibizumab

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Female
• Fluorescein Angiography
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Ranibizumab (therapeutic use)
• Receptors, Vascular Endothelial Growth Factor (therapeutic use)
• Recombinant Fusion Proteins (therapeutic use)
• Retreatment
• Retrospective Studies
• Subretinal Fluid
• Time-to-Treatment
• Tomography, Optical Coherence
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (drug effects, physiology)
• Wet Macular Degeneration (drug therapy, physiopathology)