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Differences of frequency in administration of ranibizumab and bevacizumab in patients with neovascular AMD

Unterschiede in der Anzahl der Verabreichung von intravitrealem Ranibizumab und Bevacizumab bei Patienten mit neovakulärer AMD

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Summary

Purpose

Intravitreal ranibizumab or bevacizumab are the most used drugs for treatment of neovascular age-related macular degeneration (nAMD). Repeated intravitreal injections represent an economic burden and may be associated with serious complications. The aim of this study is to evaluate the number of needed injections within 1 year of treatment.

Methods

55 patients over 50 years of age with nAMD and visual acuity (VA) between 20/40 and 20/320 were included. Scheduled visits and treatment were performed monthly for 1 year. After a loading dose of three intravitreal injections (either ranibizumab = group 1 or bevacizumab = group 2), an “as needed” regimen was performed. Primary endpoint was a difference in the injection frequencies of ranibizumab and bevacizumab. Secondary endpoints were best corrected visual acuity (BCVA) and central retinal thickness (CRT).

Results

Difference in number of injections was not significant (5.00 ± 1.67 (ranibizumab group) vs. 5.80 ± 2.28 (bevacizumab group), p = 0.084). Mean BCVA was 59.12 ± 16.64 letters after 12 months if patients received ranibizumab (p = 0.001) and 64.75 ± 17.03 letters if patients received bevacizumab (p = 0.037). There was no statistical significance between the two groups (p = 0.631). The mean CRT did not differ significantly between groups after 12 months (315.67 ± 65.86 µm for ranibizumab, 350.47 ± 102.84 µm for bevacizumab, p = 0.088).

Conclusion

There was no difference in number of treatment, BCVA and CRT after 1 year between ranibizumab and bevacizumab in patients with nAMD.

Zusammenfassung

Zielsetzung

Intravitreal verabreichtes Ranibizumab oder Bevacizumab sind die am häufigsten verwendeten Medikamente in der Behandlung der neovaskulären Form der altersbedingten Makuladegeneration (nAMD). Wiederholte Verabreichung bedeutet einerseits eine ökonomische Belastung und birgt andererseits das Risiko ernsthafter Komplikationen. Ziel dieser Studie ist die Evaluierung der Anzahl der verabreichten intravitrealen Injektionen über den Zeitraum eines Jahres.

Methoden

55 Patienten über 50 Jahre mit nAMD und einem Visus zwischen 20/40 und 20/320 wurden eingeschlossen. Über den Zeitraum von 1 Jahr wurden monatliche Kontrollen und gegebenenfalls Behandlungen durchgeführt. Nach einer „loading dose“ von 3 intravitrealen Injektionen (entweder Ranibizumab = Gruppe 1 oder Bevacizumab = Gruppe 2) wurde ein „as needed“ Regime etabliert. Primärer Endpunkt war ein Unterschied in der Anzahl der Injektionen zwischen Gruppe 1 und 2. Sekundäre Endpunkte waren der best – korriegierte Visus (BCVA) und die zentrale Retinadicke (CRT).

Ergebnisse

Der Unterschied in der Anzahl der Injektionen war statistisch nicht signifikant (5,00 ± 1,67 (Ranibizumab Gruppe) zu 5,80 ± 2,28 (Bevacizumab Gruppe), p = 0,084). Der mittlere BCVA betrug 59,12 ± 16,64 Buchstaben nach 1 Jahr in Gruppe 1 (p = 0,001) und 64,75 ± 17,03 Buchstaben in Gruppe 2 (p = 0,037). Es zeigte sich keine statistische Signifikanz zwischen den beiden Gruppen (p = 0,631). Die mittlere CRT nach einem Jahr unterschied sich nicht statistisch signifikant zwischen Gruppe 1 und 2 (315,67 ± 65.86 µm bei Ranibizumab, 350,47 ± 102,84 µm bei Bevacizumab, p = 0,088).

Schlussfolgerung

Es zeigte sich kein relevanter Unterschied in der Anzahl der Behandlungen, des BCVA oder der CRT zwischen Ranibizumab und Bevacizumab bei der Behandlung der nAMD.

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Acknowledgements

Andreas Scholler and Sibylla Richter-Müksch didn’t receive any unrestricted grants during the last 5 years. Birgit Weingessel and Pia Veronika Vécsei-Marlovits received unrestricted grants from Novartis Austria during the last 5 years.

Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Ophthalmology, Hietzing Hospital, Vienna, Austria

    Andreas Scholler MD,  Sibylla Richter-Mueksch MD,  Birgit Weingessel MD &  Pia-Veronika Vécsei-Marlovits MD, MSc, MBA

  2. Karl Landsteiner Institute for Process Optimization and Quality-management in Cataract Surgery, Vienna, Austria

    Andreas Scholler MD,  Sibylla Richter-Mueksch MD,  Birgit Weingessel MD &  Pia-Veronika Vécsei-Marlovits MD, MSc, MBA

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  1. Andreas Scholler MD
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  2. Sibylla Richter-Mueksch MD
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  3. Birgit Weingessel MD
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  4. Pia-Veronika Vécsei-Marlovits MD, MSc, MBA
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Corresponding author

Correspondence to Pia-Veronika Vécsei-Marlovits MD, MSc, MBA.

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Scholler, A., Richter-Mueksch, S., Weingessel, B. et al. Differences of frequency in administration of ranibizumab and bevacizumab in patients with neovascular AMD. Wien Klin Wochenschr 126, 355–359 (2014). https://doi.org/10.1007/s00508-014-0539-z

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  • DOI: https://doi.org/10.1007/s00508-014-0539-z

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