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J. S. Rapkin; Efficacy and Safety of Intravitreal Pegaptanib Sodium in Combination With Ranibizumab as Booster Treatment in Patients With Neovascular Age-Related Macular Degeneration (NV-AMD). Invest. Ophthalmol. Vis. Sci. 2008;49(13):1173.
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To report the efficacy and safety of intravitreal pegaptanib in combination with ranibizumab as booster treatment in patients with NV-AMD.
Medical chart review of NV-AMD patients receiving pegaptanib 0.3 mg according to label at 6-week intervals in an office-based retina specialty. Two groups of patients were studied, a) patients who were treated with pegaptanib since initial injection and b) patients who were induced with ranibizumab 0.5 mg and maintained with pegaptanib. Additional booster treatments with ranibizumab were administered to patients in both groups if deemed necessary by the treating physician. Patients with 1 year follow-up were included in the first group and patients with at least 3 months of maintenance with pegaptanib were included in the second group. Visual acuity (VA) was assessed using Snellen charts.
Thirty-one patients were treated with 9 pegaptanib injections for 1 year with booster treatment as needed. Among these patients, 11 (35%) gained at least 1 line, 17 (54%) lost < 1 line, and 27 (87%) lost < 3 lines of VA. Seven (23%) patients received booster treatments. There were no cases of retinal pigment epithelial tear or endophthalmitis. Similar results were observed in the analysis of the 42 patients who were induced with ranibizumab and maintained with pegaptanib for at least 3 months. Among these patients, 23 (55%) gained at least 1 line, 32 (76%) lost < 1 line, and 39 (93%) lost < 3 lines of VA. Ten (24%) patients received booster treatments. There were 2 (5%) cases of retinal pigment epithelial tear but no cases of endophthalmitis.
The combination of pegaptanib sodium and booster treatments with ranibizumab following or not an induction phase with ranibizumab may be a promising alternative in the treatment of patients with NV-AMD. Randomized controlled trials are needed to confirm this hypothesis.
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