Initiation and maintenance of a Treat-and-Extend regimen for ranibizumab therapy in wet age-related macular degeneration: recommendations from the UK Retinal Outcomes Group

Figures & data

Table 1 Publications providing evidence for the use of ranibizumab in a T&E regimen for wAMD

Study	Population	Intervention	Outcomes	Topline results	Study duration
RCT studies
Berg et al 2016^Citation39 (LUCAS)	People with previously untreated AMD (n=441)	Ranibizumab Bevacizumab	Mean change in VA at 2 years	+6.6 letters at year 2 in ranibizumab group	24 months
Wykoff et al 2015^Citation11 (TREX)	People with treatment-naïve wAMD (n=20)	Ranibizumab	Mean BCVA change from baseline	+10.5 letters at year 1	12 months
Silva et al 2018^Citation32 (TREND)	People with treatment-naïve wAMD (n=323)	Ranibizumab	Change in BCVA from baseline	+6.2 letters at year 1	12 months
Non-RCT studies
Abedi et al 2014^Citation42	People with CNV due to AMD (n=120 at 12 months and 101 at 24 months)	Ranibizumab Bevacizumab	% losing <15 letters and change in BCVA	97.5% and 95% lost <15 letters at 12 and 24 months, +9.5 and +8 letters at 12 and 24 months	24 months
Toalster et al 2013^Citation34	People with CNV due to AMD (n=45)	Ranibizumab	Change in BCVA	+7 letters at month 12 (P=0.008)	12 months
Arnold et al 2015^Citation41	People with CNV due to AMD (n=1,011)	Ranibizumab Aflibercept Bevacizumab	Change in BCVA	+5.3 letters at 24 months	24 months
Calvo et al 2014^Citation43	People with CNV due to AMD (n=30 for PRN and n=30 for TREX)	Ranibizumab PRN and TREX	Change in BCVA of PRN vs TREX	No significant difference in BCVA change between groups (P>0.05)	36 months
Chen et al 2016^Citation44	People with CNV due to AMD (n=79)	Ranibizumab	Change in BCVA after induction and extension phases	+8.4 letters during the induction (P<0.001) with maintenance over TREX phase (P=0.81)
Gupta et al 2010^Citation16	People with CNV due to AMD (n=92)	Ranibizumab	Change in Snellen VA	Significant improvement at 1 year (P<0.001) and 2 years (P=0.002) follow-up	24 months
Hatz and Prünte 2016^Citation37	People with CNV due to AMD (n=70 for PRN and n=70 for TREX)	Ranibizumab PRN and TREX	Change in BCVA of PRN vs TREX	+0.18 for TREX vs +0.07 for PRN at month 12 (P=0.001)	12 months
Mrejen et al 2015^Citation45	People with CNV due to AMD (n=185)	Ranibizumab Aflibercept Bevacizumab	Change in BCVA	−0.1245 logMAR at 18 months, −0.1061, −0.0896, and −0.0782 logMAR at 3, 4, and 5 years	72 months
Oubraham et al 2011^Citation36	People with CNV due to AMD (n=52 for PRN and n=38 for TREX)	Ranibizumab	Change in BCVA of PRN vs TREX	+10.8 letters for TREX vs +2.3 for PRN at month 12 (P=0.036)	12 months
Rayess et al 2015^Citation35	People with CNV due to AMD (n=189)	Ranibizumab Bevacizumab	Change in BCVA	+11.6 letters at year 1, +10.7 at year two and +13.6 at year 3	36 months
Vardarinos et al 2017^Citation10	People with CNV due to AMD (n=54 people at 12 months and n=45 people at 24 months)	Ranibizumab	Change in BCVA at 12 and 24 months	+8.3 letters at month 12 (P<0.001) and +5.2 letters at month 24 (P=0.007)	24 months
Gillies et al 2015^Citation46,a	People with AMD (n=1,043)	Ranibizumab Bevacizumab Aflibercept	Change in mean VA	+6.3 letters at month 6, remained above baseline for 5 years and decreased to −2.6 letters at year 7	84 months

Notes:

a This was not specifically a Treat-and-Extend study; however, the Treat-and-Extend approach seemed to have been favored by investigators.

Abbreviations: CNV, choroidal neovascularization; PRN, pro re nata; VA, visual acuity; BCVA, best corrected visual acuity; TREX, treat and extend; T&E, Treat and Extend; wAMD, wet age-related macular degeneration.

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