Ranibizumab treatment for neovascular age-related macular degeneration: from randomized trials to clinical practice

• Published in: Eye (London) Vol. 23; no. 8; pp. 1633 - 1640
• Main Authors: Michalova, K, Wickremasinghe, S S, Tan, T H, Chang, A, Harper, C A, Downie, J A, Hunyor, A P, Guymer, R H
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-08-2009; Nature Publishing Group
• Subjects: Aged; Aged, 80 and over; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Australia; Choroidal Neovascularization - drug therapy; clinical-study; Cohort Studies; Female; Humans; Immunologic Factors - therapeutic use; Laboratory Medicine; Macular Degeneration - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Pharmaceutical Sciences/Technology; Randomized Controlled Trials as Topic; Ranibizumab; Retrospective Studies; Surgery; Surgical Oncology; Visual Acuity; Australia; choroidal neovascular membrane; age-related macular degeneration; ranibizumab
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2009.175

Background
Although randomized clinical trials (ANCHOR and MARINA) have shown excellent results of ranibizumab treatment in patients with neovascular age-related macular degeneration (AMD), it is unclear whether such an outcome is achievable in daily practice. We evaluated the results of ranibizumab treatment for neovascular AMD in clinical practice in Australia.
Methods
A retrospective chart review of patients in four practices injected with ranibizumab in 2006 for AMD. Patients who had been diagnosed with subfoveal choroidal neovascular membrane in the preceding 6 months and had completed at least 6 months follow-up were enrolled. No standard treatment protocols were required. The main outcome measure was visual acuity (VA) at 6 and 12 months.
Results
A total of 158 patients fulfilled the entry criteria. The mean baseline VA (decimal) was 0.35±0.21 (Snellen equivalent 6/17). At 6 months, the mean VA improved to 0.46±0.27 (6/13) and remained stable until month 12 (0.48±0.30). The improvement in VA between baseline and months 6 and 12 was statistically significant (
P
<0.0001). Both the mean and the median number of injections were four in the first 6 months and nine at 12 months. VA results were comparable with those of the ANCHOR and MARINA trials, and were achieved with a lower number of injections (
P
<0.0001).
Conclusion
VA results achieved in daily clinical practice using ranibizumab for neovascular AMD are similar to large prospective randomized trials.