Abstract
Purpose: :
To compare the number of intravitreal injections required with bevacizumab (Avastin) and ranibizumab (Lucentis) for the treatment of wet age-related macular degeneration (AMD) over a one-year period.
Methods: :
Retrospective comparison of Avastin to Lucentis for the treatment of wet AMD. Criteria for inclusion were 1) initial injection with either Avastin 1.25mg or Lucentis 0.5 mg between June 1, 2006 and November 30, 2006, 2) no previous treatment for macular degeneration in the eye being studied, 3) at least one year of follow up, and 4) no other treatment modalities, crossover to other anti-VEGF treatments, or changes in the dose of the respective agent in the one-year period. Typically, Lucentis patients were treated with a series of 3 injections followed by PRN dosing, based on the PrONTO protocol, while Avastin patients received a single baseline injection followed by PRN dosing. Primary outcome was the total number of injections required in a one-year period. Visual acuities were recorded at all visits.
Results: :
Fifteen consecutive eyes treated with Lucentis were compared with 50 consecutive eyes treated with Avastin. There were no statistically significant differences between the groups at baseline with respect to age, gender, phakic status, eye injected (OD vs. OS), or visual acuity. The median [quartiles] number of injections in the Avastin group was 3.00 [2.00, 4.00], compared with a median of 5.00 [3.00, 6.00] in the Lucentis group. The Mann-Whitney test showed this to be a statistically significant difference (P=0.0060). There were no statistically significant differences in visual outcome between the two groups.
Conclusions: :
Using widely accepted treatment protocols, eyes treated with Avastin 1.25 mg for wet AMD require fewer injections per year than eyes treated with Lucentis 0.5mg. This difference may have significant implications with respect to treatment burden, cost of treatment, and the risk of complications related to intravitreal injection.
Keywords: age-related macular degeneration • vascular endothelial growth factor • injection