Topical bromfenac as an adjunctive treatment with intravitreal ranibizumab for exudative age-related macular degeneration.

Abstract

PURPOSE:

Intravitreal injection of ranibizumab is highly effective for wet age-related macular degeneration. Its limitation is that most patients require repeated intravitreal injections to achieve and maintain the visual gain. We assessed the effectiveness of adjunctive topical bromfenac, a nonsteroidal antiinflammatory drug, with ranibizumab.

METHODS:

Patients with wet age-related macular degeneration with lesions smaller than 2 disk diameters were randomized 2:3 to adjunctive topical bromfenac (n = 16) or sham (n = 22) and a 0.5-mg ranibizumab injection in a double-masked fashion. Subjects were examined monthly, and ranibizumab was injected as needed from baseline. The primary endpoint was the comparison of the number of ranibizumab injections over 6 months. The visual and anatomic responses also were compared.

RESULTS:

The mean number of ranibizumab injections over 6 months was 2.2 in the bromfenac group and 3.2 in the sham, a difference that reached significance (P = 0.0274). The changes in visual acuity did not differ significantly (P = 0.3141) although the central retinal thickness was tended to decrease more in bromfenac group (P = 0.0604). Multivariate analysis showed that topical bromfenac is significantly associated with fewer ranibizumab injections.

CONCLUSION:

Topical bromfenac might reduce the frequency of ranibizumab over 6 months in eyes with relatively small age-related macular degeneration lesions.

• Authors: Fumi Gomi, Miki Sawa, Motokazu Tsujikawa, Kohji Nishida
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 32 Issue 9 Pg. 1804-10 (Oct 2012) ISSN: 1539-2864 [Electronic] United States
• PMID: 22718152 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Anti-Inflammatory Agents, Non-Steroidal
• Antibodies, Monoclonal, Humanized
• Benzophenones
• Bromobenzenes
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• bromfenac
• Ranibizumab

Topics

• Administration, Topical
• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Benzophenones (administration & dosage)
• Bromobenzenes (administration & dosage)
• Double-Blind Method
• Drug Therapy, Combination
• Exudates and Transudates
• Female
• Fluorescein Angiography
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Ranibizumab
• Tomography, Optical Coherence
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)
• Wet Macular Degeneration (diagnosis, drug therapy, physiopathology)