Large Australian study supports as-needed dosing of bevacizumab for wet AMD

This retrospective study reports results for one of the largest cohorts to date of wet age-related macular degeneration (AMD) patients treated with intravitreal bevacizumab. The authors found that the study's 210 patients (231 eyes), who were followed for up to 12 months, experienced significant functional and anatomical improvements. However, six-month data was available for less than 30 percent of the original cohort and 12-month data for just 7.8 percent.

Subjects were patients with choroidal neovascularization resulting from wet AMD seen at one vitreoretinal practice in Australia. They were treated with 1.25 mg intravitreal bevacizumab. Patient data were collected for 12 months or until a patient's treatment was changed to ranibizumab.

The subjects experienced significant improvements in visual acuity and central retinal thickness (CRT) at one month, which continued throughout the follow-up period. Vision improved from logMAR equivalent 0.76 to 0.68 (P < ?0.001). CRT decreased from 306 mm to 244 mm (P < 0.001). Ocular complications of post-injection inflammation/uveitis occurred in eight cases (3.5 percent) and systemic side effects in 0.4 percent.

The authors say the lack of long-term follow up in many patients was due to the approval of ranibizumab (Lucentis) for the treatment of wet AMD, after which many patients switched to this therapy. Despite the study's high drop-out rate, the authors say the results clearly demonstrate the efficacy and safety of bevacizumab for the treatment of wet AMD and support the findings of previous studies. They say that the study's as-required dosing regimen of 1.25 mg intravitreal bevacizumab assessed every four to six weeks appears to be effective. They add that further studies are needed to confirm the therapy's long-term safety and efficacy.