Sanjeeb Bhandari1, Vuong Nguyen2, Jennifer Arnold3, Stephanie Young4, Gayatri Banerjee5, Mark Gillies2, Daniel Barthelmes6. 1. Save Sight Institute, Discipline of Ophthalmology and Eye Health, Sydney Medical School, The University of Sydney, Sydney, Australia. Electronic address: sbha5189@uni.sydney.edu.au. 2. Save Sight Institute, Discipline of Ophthalmology and Eye Health, Sydney Medical School, The University of Sydney, Sydney, Australia. 3. Marsden Eye Specialists, Parramatta, Australia. 4. Gladesville Eye Specialists, Gladesville, Australia. 5. Nepean Valley Eye Surgeons, Nepean, Australia. 6. Save Sight Institute, Discipline of Ophthalmology and Eye Health, Sydney Medical School, The University of Sydney, Sydney, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Abstract
PURPOSE: Ranibizumab and aflibercept are both approved for the treatment of neovascular age-related macular degeneration (nAMD). Herein, we compare the 3-year treatment outcomes of the 2 in routine clinical practice. DESIGN: Retrospective analysis of data from a prospectively designed observational outcomes registry, the Fight Retinal Blindness! PARTICIPANTS: Treatment-naïive eyes starting nAMD treatment from December 1, 2013 through December 31, 2015, with either ranibizumab or aflibercept that were tracked in the registry. METHODS: Visual acuity (VA) was analyzed annually in completers (those who completed 3 years of treatment) and in all eyes (completers, noncompleters, and those who switched treatment ). MAIN OUTCOME MEASURES: The primary outcome was mean change in VA (number of letters read on a logarithm of the minimum angle of resolution chart). RESULTS: A total of 965 eyes of 897 patients (ranibizumab, 499 eyes [469 patients]; aflibercept, 466 eyes [432 patients) were identified. The mean VA and the type of the choroidal neovascularization (CNV) at the start of treatment were similar between the 2 groups. The group receiving ranibizumab was older. The crude mean VA change of +1.5 letters (95% confidence interval [CI], 0-3.1 letters) in the ranibizumab group and of +1.6 letters (95% CI, -0.2 to 3.3 letters; P = 0.97) in the aflibercept group at 3 years in all eyes was similar, as was the adjusted mean VA change, +0.3 letters (95% CI, -1.5 to 2.0 letters) versus +1.0 letters (95% CI, -0.7 to 2.8 letters; P = 0.66). Both treatment groups received a median of 18 injections from a median of 21 clinical visits. The adjusted proportion of clinical visits when the CNV was graded active over 3 years was similar between ranibizumab (43%) and aflibercept (51%; P = 0.9). More switches from ranibizumab to aflibercept (P < 0.001) took place than vice versa. The proportion of eyes that did not complete 3 years of treatment in each of the group was similar (P = 0.21). CONCLUSIONS: Neither ranibizumab nor aflibercept was superior to the other in terms of VA outcomes and treatment frequency at 3 years for nAMD.
PURPOSE: Ranibizumab and aflibercept are both approved for the treatment of neovascular age-related macular degeneration (nAMD). Herein, we compare the 3-year treatment outcomes of the 2 in routine clinical practice. DESIGN: Retrospective analysis of data from a prospectively designed observational outcomes registry, the Fight Retinal Blindness! PARTICIPANTS: Treatment-naïive eyes starting nAMD treatment from December 1, 2013 through December 31, 2015, with either ranibizumab or aflibercept that were tracked in the registry. METHODS: Visual acuity (VA) was analyzed annually in completers (those who completed 3 years of treatment) and in all eyes (completers, noncompleters, and those who switched treatment ). MAIN OUTCOME MEASURES: The primary outcome was mean change in VA (number of letters read on a logarithm of the minimum angle of resolution chart). RESULTS: A total of 965 eyes of 897 patients (ranibizumab, 499 eyes [469 patients]; aflibercept, 466 eyes [432 patients) were identified. The mean VA and the type of the choroidal neovascularization (CNV) at the start of treatment were similar between the 2 groups. The group receiving ranibizumab was older. The crude mean VA change of +1.5 letters (95% confidence interval [CI], 0-3.1 letters) in the ranibizumab group and of +1.6 letters (95% CI, -0.2 to 3.3 letters; P = 0.97) in the aflibercept group at 3 years in all eyes was similar, as was the adjusted mean VA change, +0.3 letters (95% CI, -1.5 to 2.0 letters) versus +1.0 letters (95% CI, -0.7 to 2.8 letters; P = 0.66). Both treatment groups received a median of 18 injections from a median of 21 clinical visits. The adjusted proportion of clinical visits when the CNV was graded active over 3 years was similar between ranibizumab (43%) and aflibercept (51%; P = 0.9). More switches from ranibizumab to aflibercept (P < 0.001) took place than vice versa. The proportion of eyes that did not complete 3 years of treatment in each of the group was similar (P = 0.21). CONCLUSIONS: Neither ranibizumab nor aflibercept was superior to the other in terms of VA outcomes and treatment frequency at 3 years for nAMD.
Authors: Ki Won Jin; Jae Hui Kim; Jun Young Park; Sang Jun Park; Kyu Hyung Park; Joo Yong Lee; Se Joon Woo Journal: Sci Rep Date: 2021-07-16 Impact factor: 4.379
Authors: Frank D Verbraak; Dirk L Ponsioen; Odette A M Tigchelaar-Besling; Vuong Nguyen; Mark C Gillies; Daniel Barthelmes; Caroline C W Klaver Journal: Acta Ophthalmol Date: 2020-12-23 Impact factor: 3.761