Abstract
Purpose: :
To conduct a meta-analysis comparing ranibizumab to bevacizumab in the treatment of neovascular, age-related macular degeneration.
Methods: :
Studies published from January 2006 through February 2008 were identified from electronic databases (MEDLINE, BIOSIS), bibliographies of pertinent review articles and pertinent original articles, textbooks, and expert consultation. From 18 potentially relevant references retrieved, six were studies investigating the effect of bevacizumab or ranibizumab on neovascular, age-related macular degeneration that fit the following inclusion criteria: intravitreal injection of agent, adequate data included to determine mean change in visual acuity, only one agent examined per study, and no earlier or later publication of identical data. The six studies were analyzed using random effects modeling.
Results: :
Visual acuity improvement was associated with both ranibizumab treatment (summary mean change in visual acuity +18.0 letters from baseline, p < 0.001) and bevacizumab treatment (summary mean change in visual acuity +16.0 letters from baseline, p = 0.020). The benefit in visual acuity was maintained for each of the six study durations (3-12 months). Funnel plot of visual acuity mean versus standard error demonstrated little asymmetry indicating minimal bias. Tests of heterogeneity (Q value = 0.349, I squared = 0.000) showed studies to be homogeneous.
Conclusions: :
Summary results indicate that intravitreal bevacizumab is comparably effective to intravitreal ranibizumab in the treatment of neovascular, age-related macular degeneration.
Keywords: age-related macular degeneration • neovascularization • vascular endothelial growth factor