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Ranibizumab for eyes previously treated with pegaptanib or bevacizumab without clinical response.

AbstractBACKGROUND AND OBJECTIVE:
To assess the safety and efficacy of ranibizumab in patients who had inadequate response to pegaptanib or bevacizumab.
PATIENTS AND METHODS:
In this single-center study, 19 patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD) previously treated with pegaptanib (n = 1), bevacizumab (n = 13), or both (n = 5) received 12 monthly ranibizumab injections (0.5 mg). Outcomes were measured from start of previous therapy (baseline) to start of ranibizumab treatment (day 0) through 12 months.
RESULTS:
No drug- or injection-related adverse events and no serious adverse events were reported. At 6 and 12 months, 4 and 5 patients gained 3 or more lines of VA, respectively; 3 patients lost less than 3 lines of VA at 6 months, and 6 patients lost less than 3 lines at 12 months. At 6 and 12 months, VA increased by a mean (± standard error of the mean) of 2.06 ± 1.23 and 1.17 ± 0.62 lines, respectively. Central retinal thickness decreased by a mean of 62.65 ± 22.46 and 62.16 ± 29.20 μm at months 6 and 12, respectively. When stratified by pigment epithelial detachment (PED) status, patients without PED had better visual and anatomical outcomes than patients with PED.
CONCLUSION:
Ranibizumab has favorable safety and efficacy profiles for patients with AMD without previous response to pegaptanib or bevacizumab.
AuthorsRichard S Kaiser, Omesh P Gupta, Carl D Regillo, Allen C Ho, Mitchell S Fineman, James F Vander, J Arch McNamara, Gary C Brown
JournalOphthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye (Ophthalmic Surg Lasers Imaging) 2012 Jan-Feb Vol. 43 Issue 1 Pg. 13-9 ISSN: 1938-2375 [Electronic] United States
PMID21986085 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2012, SLACK Incorporated.
Chemical References
  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Aptamers, Nucleotide
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • pegaptanib
  • Bevacizumab
  • Ranibizumab
Topics
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors (therapeutic use)
  • Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
  • Aptamers, Nucleotide (therapeutic use)
  • Bevacizumab
  • Drug Substitution
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Ranibizumab
  • Retreatment
  • Tomography, Optical Coherence
  • Treatment Failure
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A (antagonists & inhibitors)
  • Visual Acuity (physiology)
  • Wet Macular Degeneration (drug therapy, physiopathology)

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