Comparative study of 1+PRN ranibizumab versus bevacizumab in the clinical setting

Figures & data

Table 1 Inclusion and exclusion criteria

Inclusion criteria

Age-related macular degeneration

Subfoveal CNV

BCVA ≥ 20/1000

Patients must be age 50 years or older

Patients must sign a written informed consent form

In cases of bilateral disease, only the right eye was included

Exclusion criteria

Previous treatment for wet AMD, including laser, radiation, PDT, or any anti-VEGF therapy

Patients who present with CNV due to other causes than AMD, including pathological myopia, ocular histoplasmosis syndrome, angioid streaks, multifocal choroiditis, choroidal rupture

Patients with any retinal vasculopathies, including diabetic retinopathy, retinal vein occlusions, etc, in the study eye

Patients with previous subfoveal or juxtafoveal laser treatment

Patients with concomitant diseases in the study eye such as uveitis, retinal pigment epithelium rips, central serous corioretinopathy, acute ocular or peri-ocular infection

Patients with advanced glaucoma or intraocular pressure in the study eye > 22 mmHg in spite of adequate treatment or medication

Premenopausal women not using adequate contraception

Abbreviations: AMD, age-related macular degeneration; CNV, choroidal neovascularization; PDT, photodynamic therapy; VEGF, vascular endothelial growth factor; BCVA, best-corrected visual acuity.

Table 2 Baseline characteristics of the patients

	Ranibizumab (n = 67)	Bevacizumab (n = 91)	P
Age – mean (±SD)	77.1 (±7.1)	76.5 (±8.0)	0.61a
Males – n (%)	28 (41.8%)	37 (40.7%)	0.997b
Initial BCVA mean (±SD)	41.5 (±22.8)	40.6 (±20.5)	0.72a
Initial foveal thickness mean (±SD)	318.3 (±136.9)	287.0 (±147.9)	0.19a
Angiographic lesion subtype
Predominantly classic	17	12
Minimally classic	18	31	0.22b
Occult with no classic	24	39
RAP	8	9

Notes:

a Pearson chi-square;

b independent sample t-test.

Abbreviations: BCVA, best corrected visual acuity in ETDRS scores; SD, standard deviation; RAP, retinal angiomatous proliferation.

Figure 1 Twelve-month variation of best corrected visual acuity in patients treated for wet age-related macular degeneration either with bevacizumab or ranibizumab.

Abbreviation: ETDRS, Early Treatment Diabetic Retinopathy Study.

Figure 2 Twelve-month variation in central foveal thickness using OCT in patients treated for wet age-related macular degeneration either with bevacizumab or ranibizumab.

Abbreviation: OCT, ocular coherence tomography.

Figure 3 Central foveal thickness measured using OCT throughout 12 months of treatment with either bevacizumab or ranibizumab.

Abbreviation: OCT, ocular coherence tomography.

Table 3 Outcome measures at month 12

	Ranibizumab (n = 60)	Bevacizumab (n = 85)	P
Change from baseline BCVA score
Mean no of letters	6.65 (±13.9)	5.59 (±13.2)	0.64a
Increase of ≥15 letters (%)	15 (25.0)	21 (24.7)	0.97b
Increase of >0 letters (%)	42 (70.0)	56 (65.9)	0.60b
Decrease of ≥15 letters (%)	3 (5.0)	7 (8.2)	0.45b
Foveal thickness (μm)
Mean (±SD)	206.6 (±94.7)	196.7 (±93.3)	0.53a
Mean change from baseline (±SD)	−115.1 (±120.9)	−85.3 (±143.2)	0.19a
Mean no of treatments (±SD)	5.97 (±2.15)	5.92 (±2.36)	0.90a

Notes:

a Pearson chi-square;

b independent sample t-test;

c only 84 patients treated with bevacizumab had OCT data available at month 12.

Abbreviations: BCVA, best corrected visual acuity in Early Treatment Diabetic Retinopathy Study scores; RAP, retinal angiomatous proliferation.

Table 4 Number of initial consecutive injections to achieve a dry macula

	Ranibizumab n (%)	Bevacizumab n (%)
1 inj	3 (5.0)	6 (7.1)
2 inj	12 (20.0)	16 (18.8)
3 inj	10 (16.7)	26 (30.6)
4 inj	10 (16.7)	11 (12.9)
5 inj	13 (21.7)	8 (9.4)
6 inj	6 (10.0)	6 (7.1)
7 inj	0 (0)	4 (4.7)
8 inj	2 (3.3)	1 (1.2)
9 inj	2 (3.3)	5 (5.9)
10 inj	2 (3.3)	2 (2.4)
Meana	4.20 inj	3.96 inj

Notes:

a Difference between the mean number initial consecutive injections performed per eye in each group was not statistically significant (P = 0.53; independent samples t-test).