Bevacizumab noninferior to ranibizumab for AMD

This head-to-head comparison found that bevacizumab was noninferior to ranibizumab for AMD in terms of BCVA and that the drugs had similar safety profiles.

The GEFAL study was a prospective, double-masked, randomized clinical trial that included 501 patients aged ≥ 50 years enrolled at 38 centers in France. They were randomly assigned to receive 1.25 mg bevacizumab or 0.50 mg ranibizumab. The noninferiority limit was five letters.

At one year, the mean number of letters gained was 5.4 in the bevacizumab group and 3.6 in the ranibizumab group. The number of injections also was similar for both drugs: 6.8 for the bevacizumab group and 6.5 for the ranibizumab group (P = 0.39).

Safety profiles also were similar, with no differences in safety noted or new concerns identified. Use of each drug led to a substantial and rapid decrease in the amount of subretinal and intraretinal fluid, although at the final evaluation, more eyes had complete resolution of fluid with ranibizumab than bevacizumab.

The authors note that these findings are similar to those of the CATT study, which demonstrated that bevacizumab and ranibizumab had equivalent effects on visual acuity at one year and at two years. However, more subtle differences in comparative efficacy might exist, as is suggested by the trend of reduced macular thickness and fluid and dye leakage with ranibizumab, which should be assessed in future studies.