• 12-Month Outcomes of Ranibizumab vs. Aflibercept for Neovascular AMD

    By Marianne Doran and edited by Susan M. MacDonald, MD

    Journal Highlights

    Ophthalmology, December 2016

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    Although the VIEW I and II random­ized controlled studies compared ran­ibizumab and aflibercept for neovas­cular age-related macular degeneration (nAMD), Gillies et al. sought to com­pare the visual acuity (VA) outcomes between the 2 drugs as used in routine clinical practice. At 12 months, they found no signif­icant difference in the VA outcomes nor in the number of injections between these anti-VEGF agents.

    This was an observa­tional database study of 394 treatment-naïve eyes with nAMD in the Fight Retinal Blindness outcome registry. Anti-VEGF therapy was started with ranibizumab (n = 197) or aflibercept (n = 197) between Dec. 1, 2013, and Jan. 31, 2015. Eyes were matched at baseline for VA, age, and choroidal neovascular membrane (CNV) size. The main outcome measures were change in mean VA, number of injec­tions and visits, and proportion of eyes with inactive CNV over 12 months.

    The mean (standard deviation) VA of ranibizumab-treated eyes increased from 58.6 (20.3) letters at baseline to 62.3 (23.9) for a gain of 3.7 letters, compared with 58.9 (19.2) letters at baseline to 63.1 (21.5) for a gain of 4.26 letters in aflibercept-treated eyes. The difference in change in the crude VA of 0.6 letters between the 2 groups was not statistically significant, nor was the difference in adjusted mean VA of the 2 groups. Among participants who completed the study, the mean num­bers of injections (8.1 vs. 8.0; p = .27) and visits (9.6 vs. 9.5; p = .15) did not differ between the ranibizumab and aflibercept groups, respectively. Similar­ly, there was no significant difference in the proportion of eyes in which the CNV was graded as inactive (ranibizumab, 74%; aflibercept, 77%; p = .63).

    The researchers concluded that both ranibizumab and aflibercept delivered similar, good outcomes after 12 months of treatment for nAMD in routine clinical practice and that there was no difference in treatment frequency be­tween the 2 drugs. They acknowledged that the lack of prospective random­ization is a weakness of this study but said that their data were likely to reflect real-world practice and outcomes.

    The original article can be found here.