Author(s):Stepien KE, Rosenfeld PJ, Puliafito CA, Feuer W, Shi W, Al-Attar L, Dubovy SR, Murray TG, Davis JL, Lee WH, Schwartz SG, Smiddy WE, Berrocal AM, Flynn HW Jr. Comparison of intravitreal bevacizumab followed by ranibizumab for the treatment of neovascular age-related macular degeneration. Retina. 2009 Sep;29(8):1067-73. doi: 10.1097/IAE.0b013e3181b1bb06. PMID 19696701
PURPOSE To compare outcomes after switching from intravitreal bevacizumab (Avastin) to ranibizumab (Lucentis) in patients with neovascular age-related macular degeneration (AMD).
METHODS A retrospective review was performed of patients with neovascular AMD who were switched from treatment with intravitreal bevacizumab to intravitreal ranibizumab once ranibizumab became commercially available. All reviewed patients had at least three bevacizumab injections before being switched to ranibizumab. The treatment outcomes included comparisons of visual acuity and dosing frequency while receiving both drugs.
RESULTS Eighty-four eyes met the inclusion criteria. Mean baseline visual acuity was 20/100. Mean duration of bevacizumab treatment was 7.1 months followed by 7.3 months with ranibizumab (P = 0.68). Best-obtained visual acuity during treatment was 20/63 with bevacizumab and 20/63 with ranibizumab (P = 0.5). Last mean visual acuity after receiving bevacizumab at the time of the first ranibizumab injection was 20/80. Mean visual acuity at the last ranibizumab follow-up visit was 20/80 (P = 0.49). Mean injection rates per month while receiving bevacizumab and ranibizumab were 0.66 (P = 0.98).
CONCLUSION In this subset of patients with neovascular AMD switched from bevacizumab to ranibizumab therapy, there were no apparent differences in visual acuity outcomes or injection rates. Larger prospective studies are under way to directly compare these drugs for the treatment of neovascular AMD.