April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Predictors of the Number of Injections among Patients Treated PRN with Ranibizumab or Bevacizumab in the Comparison of AMD Treatments Trials (CATT)
Author Affiliations & Notes
  • Daniel F Martin
    Cole Eye Institute, Cleveland Clinic, Cleveland, OH
  • Gui-Shuang Ying
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Jiayan Huang
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Maureen G Maguire
    Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Footnotes
    Commercial Relationships Daniel Martin, None; Gui-Shuang Ying, None; Jiayan Huang, None; Maureen Maguire, Amakem (F), IDx (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 869. doi:
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      Daniel F Martin, Gui-Shuang Ying, Jiayan Huang, Maureen G Maguire, ; Predictors of the Number of Injections among Patients Treated PRN with Ranibizumab or Bevacizumab in the Comparison of AMD Treatments Trials (CATT). Invest. Ophthalmol. Vis. Sci. 2014;55(13):869.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To describe the association of baseline features and drug on the number of injections administered through 2 years to eyes with neovascular age-related macular degeneration that were treated on an as needed basis (PRN) with either ranibizumab or bevacizumab.

 
Methods
 

Participants in the Comparison of AMD Treatments Trials (CATT) were randomly assigned to ranibizumab or bevacizumab and scheduled for treatment evaluation every 28 days. Eyes were treated if the examining ophthalmologist observed fluid on OCT or other signs of neovascular activity. Baseline patient demographic and health features and ocular characteristics centrally graded from color photography, fluorescein angiography, and optical coherence tomography (OCT) were investigated for their association with mean number of injections and the proportion of eyes with a low number (≤8) of injections within 2 years. Regression models using backward selection were fit to estimate adjusted means (linear regression) and adjusted odds ratios (ORs, logistic regression) and their 95% confidence intervals (CIs).

 
Results
 

Among the 598 patients assigned to PRN treatment, 501 (84%) lived through 2 years, had at least 20 out of a possible 26 opportunities for treatment, and were included for analysis. The mean number of injections (Table 1) was less with retinal angiomatous proliferation (RAP) lesions (10.6 vs 13.7; p=0.001), no subretinal fluid (11.7 vs 13.9 for extrafoveal fluid and 13.4 for foveal fluid; p=0.04), no sub-RPE fluid (11.5 vs 13.9 for extrafoveal fluid and 15.6 for fovea fluid; p<0.001), and treatment with ranibizumab (12.4 vs 14.3 for bevacizumab; p=0.002). Eyes with foveal sub-RPE fluid (OR 0.33 CI [0.20, 0.55]) or extrafoveal fluid (OR 0.58 CI [0.34, 0.99]) were less likely to have ≤8 injections than those with no sub-RPE fluid (Table 2; p<0.001).

 
Conclusions
 

Baseline predictors of a lower number of injections include RAP lesion, treatment with ranibizumab, absence of subretinal fluid, and absence of sub-RPE fluid.

     
Keywords: 412 age-related macular degeneration • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials  
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