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K. E. Stepien, P. J. Rosenfeld, C. A. Puliafito, S. R. Dubovy, J. L. Davis, A. M. Berrocal, W. E. Smiddy, H. W. Flynn, S. G. Schwartz, L. Al-Attar; Sequential Comparison of Avastin (Bevacizumab) Followed by Lucentis (Ranibizumab) in the Treatment of Neovascular Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4534.
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Intravitreal Avastin has been used off-label to treat neovascular AMD since May 2005. On June 30, 2006, the Food and Drug Administration approved Lucentis for the treatment of neovascular AMD. Since that time, many of our patients who were treated with intravitreal Avastin were switched to intravitreal Lucentis. This transition from Avastin to Lucentis provided an opportunity to retrospectively compare the sequential treatment response of patients injected with Avastin followed by Lucentis.
A retrospective review was performed of patients treated with Avastin who were subsequently treated with Lucentis. Notable outcome parameters included duration of therapy, ability to induce a fluid-free macula as assessed by optical coherence tomography, the fluid-free interval, the frequency of reinjection, and the visual acuity response.
Based on a review of billing records, we identified a total of 403 patients at the Bascom Palmer Eye Institute who transitioned from Avastin therapy to Lucentis therapy. To date, 8 records have been extensively reviewed. These records represented patients who had not achieved a fluid-free macula exceeding 6-8 weeks while receiving Avastin therapy. Of these 8 patients, 4 patients achieved a fluid free macula of at least 8 weeks duration when switched to Lucentis. Improvement in optical coherence tomography central retinal thickness was seen in 5 of the 8 patients with 3 of these patients having improvement in visual acuity and 2 patients having stable vision. Three of the 8 patients had similar limited responses to both Lucentis and Avastin. In these patients, visual acuity and optical coherence tomography findings were stable.
In this preliminary analysis of patients who required frequent retreatment with Avastin, more than 50% of patients responded more favorably to Lucentis based on optical coherence tomography findings and/or improvement in visual acuity. Complete analysis of all patients who transitioned from Avastin to Lucentis will be presented.
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