Michael T Andreoli1, Michael Pinnolis2, Troy Kieser2, Jennifer Sun3, Christopher M Andreoli4. 1. Department of Visual Services, Harvard Vanguard Medical Associates, Boston, Massachusetts;; Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois; 2. Department of Visual Services, Harvard Vanguard Medical Associates, Boston, Massachusetts; 3. Department of Visual Services, Harvard Vanguard Medical Associates, Boston, Massachusetts;; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts;; Beetham Eye Clinic, Joslin Diabetes Center, Boston, Massachusetts; 4. Department of Visual Services, Harvard Vanguard Medical Associates, Boston, Massachusetts;; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts;; Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Abstract
PURPOSE: To assess the feasibility and potential obstacles of a departmental switch from ranibizumab (Lucentis, Genentech, South San Francisco, CA) to bevacizumab (Avastin, Genentech) for the treatment of neovascular age-related macular degeneration (AMD). METHODS: A total of 154 eyes treated for wet AMD with ranibizumab or bevacizumab were examined over a 10-month period. The treatment protocol was monthly induction therapy followed by injections as needed for macular edema or subretinal fluid on optical coherence tomography, new hemorrhage or edema on examination, worsening vision, or leakage on fluorescein angiography. Central subfield thickness and pinhole vision were the main treatment outcomes. Study windows were compared using t tests and Mann-Whitney U tests. Statistical significance was defined as a P value of <0.05. RESULTS: The majority of patients (88%) were willing to accept a bevacizumab injection. There was no difference in frequency of injection, central subfield thickness, visual outcome, or endophthalmitis rate between the ranibizumab and bevacizumab groups. A small subset of patients (4.5%) appeared to respond more favorably to ranibizumab than bevacizumab. CONCLUSIONS: Bevacizumab appears to be a cost-effective alternative to ranibizumab for the treatment of neovascular AMD. Patients previously treated with ranibizumab are typically willing to switch to bevacizumab. In the overwhelming majority of patients, there is no major decline in clinical status. However, select patients may respond better to ranibizumab injections.
PURPOSE: To assess the feasibility and potential obstacles of a departmental switch from ranibizumab (Lucentis, Genentech, South San Francisco, CA) to bevacizumab (Avastin, Genentech) for the treatment of neovascular age-related macular degeneration (AMD). METHODS: A total of 154 eyes treated for wet AMD with ranibizumab or bevacizumab were examined over a 10-month period. The treatment protocol was monthly induction therapy followed by injections as needed for macular edema or subretinal fluid on optical coherence tomography, new hemorrhage or edema on examination, worsening vision, or leakage on fluorescein angiography. Central subfield thickness and pinhole vision were the main treatment outcomes. Study windows were compared using t tests and Mann-Whitney U tests. Statistical significance was defined as a P value of <0.05. RESULTS: The majority of patients (88%) were willing to accept a bevacizumab injection. There was no difference in frequency of injection, central subfield thickness, visual outcome, or endophthalmitis rate between the ranibizumab and bevacizumab groups. A small subset of patients (4.5%) appeared to respond more favorably to ranibizumab than bevacizumab. CONCLUSIONS:Bevacizumab appears to be a cost-effective alternative to ranibizumab for the treatment of neovascular AMD. Patients previously treated with ranibizumab are typically willing to switch to bevacizumab. In the overwhelming majority of patients, there is no major decline in clinical status. However, select patients may respond better to ranibizumab injections.
Authors: L G Presta; H Chen; S J O'Connor; V Chisholm; Y G Meng; L Krummen; M Winkler; N Ferrara Journal: Cancer Res Date: 1997-10-15 Impact factor: 12.701
Authors: David M Brown; Peter K Kaiser; Mark Michels; Gisele Soubrane; Jeffrey S Heier; Robert Y Kim; Judy P Sy; Susan Schneider Journal: N Engl J Med Date: 2006-10-05 Impact factor: 91.245
Authors: Julie L Gasperini; Amani A Fawzi; Ani Khondkaryan; Linda Lam; Lawrence P Chong; Dean Eliott; Alexander C Walsh; John Hwang; SriniVas R Sadda Journal: Br J Ophthalmol Date: 2011-07-26 Impact factor: 4.638
Authors: David S Friedman; Benita J O'Colmain; Beatriz Muñoz; Sandra C Tomany; Cathy McCarty; Paulus T V M de Jong; Barbara Nemesure; Paul Mitchell; John Kempen Journal: Arch Ophthalmol Date: 2004-04
Authors: Kimberly E Stepien; Philip J Rosenfeld; Carmen A Puliafito; William Feuer; Wei Shi; Luma Al-Attar; Sander R Dubovy; Timothy G Murray; Janet L Davis; Wen-Hsiang Lee; Stephen G Schwartz; William E Smiddy; Audina M Berrocal; Harry W Flynn Journal: Retina Date: 2009-09 Impact factor: 4.256
Authors: Herbert Hurwitz; Louis Fehrenbacher; William Novotny; Thomas Cartwright; John Hainsworth; William Heim; Jordan Berlin; Ari Baron; Susan Griffing; Eric Holmgren; Napoleone Ferrara; Gwen Fyfe; Beth Rogers; Robert Ross; Fairooz Kabbinavar Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: Sophie J Bakri; Melissa R Snyder; Joel M Reid; Jose S Pulido; Mohamed K Ezzat; Ravinder J Singh Journal: Ophthalmology Date: 2007-12 Impact factor: 12.079
Authors: Erin R Weeda; Elaine Nguyen; Silas Martin; Michael Ingham; Diana M Sobieraj; Brahim K Bookhart; Craig I Coleman Journal: J Mark Access Health Policy Date: 2019-10-19