July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Intraocular pressure trends in the Canadian treat and extend trial with ranibizumab in patients with nAMD: CANTREAT study 24-month results
Author Affiliations & Notes
  • Peter Kertes
    Ophthalmology and Vision Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
    Ophthalmology and Vision Sciences, The University of Toronto, Toronto, Ontario, Canada
  • Tom Sheidow
    Ivey Eye Institute, London, Ontario, Canada
  • Geoff Williams
    Calgary Retina Consultants, Calgary, Alberta, Canada
  • Mark Greve
    Alberta Retina Consultants, Edmonton, Alberta, Canada
  • Ivan Galic
    Institut de la Rétine de Montréal, Montreal, Quebec, Canada
  • Emmanouil Rampakakis
    JSS Medical Research, Saint Laurent, Ontario, Canada
  • Marcel Lahaie
    Novartis Canada, Dorval, Quebec, Canada
  • Footnotes
    Commercial Relationships   Peter Kertes, Alcon (R), Allergan (F), Allergan (R), ArcticDx (I), Bayer (F), Bayer (C), Bayer (R), Novartis (F), Novartis (C), Novartis (R), Roche (F); Tom Sheidow, Alcon (C), Bayer (C), Novartis (C), Novartis (F); Geoff Williams, Abbvie (C), Alcon (C), Alcon (F), Allergan (F), ArcticDx (I), Bayer (C), Bayer (F), Novartis (C), Novartis (F); Mark Greve, Alcon (C), Bayer (C), Novartis (C), Secure Diagnostic Imaging (I); Ivan Galic, Alcon (C), Bayer (C), Novartis (R), Novartis (C); Emmanouil Rampakakis, JSS Medical Research (E); Marcel Lahaie, Novartis (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 131. doi:
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      Peter Kertes, Tom Sheidow, Geoff Williams, Mark Greve, Ivan Galic, Emmanouil Rampakakis, Marcel Lahaie; Intraocular pressure trends in the Canadian treat and extend trial with ranibizumab in patients with nAMD: CANTREAT study 24-month results. Invest. Ophthalmol. Vis. Sci. 2019;60(9):131.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Studies have reported an association between anti-VEGF injections and rises in intraocular pressure (IOP) and glaucomatous progression. Few large clinical studies have compared treat-and-extend (T&E) to monthly ranibizumab dosing in neovascular age-related macular degeneration (nAMD). This study aimed to assess non-inferiority of ranibizumab using a T&E regimen to once-monthly (OM) in treatment-naïve nAMD patients over 36 months, and examined changes in IOP.

Methods : This is a prospective, randomized, open-label, multicenter, post-authorization non-inferiority study with patients randomized 1:1 to T&E or OM after being prescribed ranibizumab. Glaucoma patients were not excluded. This analysis describes baseline characteristics and changes in IOP after 12 and 24 months. Changes in visual acuity were previously reported.

Results : The study was approved by ethics boards at all participating sites. There were 580 patients (287 T&E: 293 OM) randomized and 462 patients (235 T&E: 226 OM) completed 24 months of follow-up. The majority of patients were Caucasian (94%) and female (60%), and the mean (SD) age was 78.8 (7.8) years. At Baseline, IOPs were comparable in the OM and T&E regimens. For those randomized to the OM regimen, the mean change in IOP was 2.6 (4.89) mmHg at 12 months and 1.5 (5.11) mmHg at 24 months compared to 2.1 (6.31) mmHg at 12 months and 1.8 (5.65) mmHg at 24 months for those randomized to the T&E regimen. Overall, IOP increases of 5-10 mmHg, >10 to ≤15 mmHg, and >15 mmHg were seen in 44 (21%), 17 (8.3%), and 2 (0.97%) at Month 12 and 45 (24%), 6 (3.2%), and 2 (1.1%) at Month 24. In the OM regimen at Month 12, 26 (26%) had an IOP rise of 5-10 mmHg, 7 (6.9%) a rise >10 to ≤15 mmHg, and 0% with >15 mmHg compared to 18 (17%), 10 (9.6%), and 2 (1.9%), respectively, in the T&E regimen. At Month 24, IOP rises of 5-10 mmHg, >10 to ≤15 mmHg, and >15 mmHg were seen in 20 (21%), 2 (2.1%), and 1 (1.1%), respectively for the OM regimen and 25 (27%), 4 (4.3%), and 1 (1%), respectively, in the T&E regimen. The number of injections administered at Month 12 and Month 24 was 11.8 (OM) and 9.4 (T&E), and 23.6 (OM) and 17.6 (T&E), respectively.

Conclusions : This analysis showed nAMD patients treated with ranibizumab were unlikely to experience a sustained rise in IOP and mean changes in IOP were generally similar between the groups.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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