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Mark C Gillies, Vincent Daien, Vuong Nguyen, Jennifer J Arnold, Nigel Morlet, Daniel Barthelmes; Twelve-month outcomes of ranibizumab versus aflibercept for neovascular age-related macular degeneration: an observational study.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):896.
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There are limited data comparing the efficacy of ranibizumab and aflibercept for the treatment of neovascular age-related macular degeneration (nAMD) and currently no substantive reason to use one drug over the other. We performed a direct comparison of visual acuity (VA) outcomes between ranibizumab and aflibercept using observational data reflecting routine clinical practice.
Treatment-naïve eyes with nAMD beginning treatment with ranibizumab or aflibercept between Dec 1, 2013 and Jan 31, 2015 were extracted from the Fight Retinal Blindness observational registry. Eyes were matched at baseline for VA, age and choroidal neovascular membrane (CNV) size prior to analysis. The primary outcome measures were change in mean VA at 12 months; number of injections and visits; proportion of eyes with inactive CNV over 12 months. Eyes that switched or discontinued treatment were included using their last observation carried forward. Adjusted means were also calculated using mixed-effects regression models adjusting for age, baseline VA, lesion size and type (fixed-effects) and practice identifier (random effect).
We analysed data from 394 eyes (197 ranibizumab and 197 aflibercept) from 372 patients. Baseline parameters were well matched. The mean VA of ranibizumab-treated eyes increased from 58.6 letters at baseline to 62.3 letters (+3.7 letters; P=0.001), compared with 58.9 letters at baseline to 63.1 letters (+4.3 letters; P<0.001) for eyes receiving aflibercept. The difference between the 2 groups of 0.6 letters was not statistically significant (P=0.76), nor was there a difference in the adjusted estimate of 1.9 letters (P=0.26). The mean number of injections and visits did not differ between ranibizumab and aflibercept (6.9 vs. 7.2 injections, P=0.90; 8.3 vs. 8.6 visits, P=0.70). The adjusted proportion of eyes becoming inactive within 12 months was similar between the eyes receiving ranibizumab and aflibercept (74% vs. 77%, P=0.63).
VA outcomes and treatment frequency at 12-months did not differ between ranibizumab and aflibercept in this large observational study.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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