Original articleComparison of Ranibizumab and Bevacizumab for Neovascular Age-Related Macular Degeneration According to LUCAS Treat-and-Extend Protocol
Section snippets
Study Patients
Between March 2009 and July 2012, 441 patients with neovascular AMD at 10 ophthalmological centers in Norway were included in a multicenter, double-blind, noninferiority trial. The patients were randomized to receive intravitreal injections of ranibizumab 0.5 mg or bevacizumab 1.25 mg in a 1:1 ratio, following a treat-and-extend protocol. Eligibility criteria included age ≥50 years, previously untreated active neovascular AMD in 1 eye, and best-corrected visual acuity (BCVA) between 20/25 and
Patients and Treatments
In total, 441 randomized patients were included in the safety analysis. All 9 patients from 1 study center were excluded because of serious protocol violations, and 1 patient was excluded after a serious retinal and vitreous hemorrhage a few days after inclusion. The remaining 431 patients were included in the intention-to-treat analysis. The per protocol analyses were performed on 371 patients who completed the 1-year visit (86%). Twenty patients were nonresponders. Of the 40 patients
Discussion
At 1 year, bevacizumab and ranibizumab had equivalent effects on visual acuity when administered according to a treat-and-extend protocol. The mean increase in BCVA was 7.9 letters in the bevacizumab group and 8.2 letters in the ranibizumab group. The improvement in visual acuity with the treat-and-extend regimen was comparable to monthly treatment in the CATT, in which the mean increase in BCVA was 8.0 letters in the bevacizumab group and 8.5 letters in the ranibizumab group.10 Thus, excellent
Acknowledgments
The authors thank the participating principal investigators in LUCAS. Norway: Lars Haakon Berger, MD, Department of Ophthalmology, Ostfold Hospital, Fredrikstad; Vegard Forsaa, MD, Department of Ophthalmology, Stavanger University Hospital, Stavanger; Kristian Fossen, Department of Ophthalmology, University Hospital of Northern Norway; Inger Gjertsen, Department of Ophthalmology, Vestre Viken Hospital, Drammen; Emina Hadzalic-Gradas, MD, Department of Ophthalmology, Betanien Hospital, Skien;
References (13)
- et al.
Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two-year results
Ophthalmology
(2012) - et al.
Ranibizumab versus bevacizumab for neovascular age-related macular degeneration: results from the GEFAL Noninferiority Randomized Trial
Ophthalmology
(2013) - et al.
Alternative treatments to inhibit VEGF in age-related choroidal neovascularisation: 2-year findings of the IVAN randomised controlled trial
Lancet
(2013) The as-needed treatment strategy for choroidal neovascularization: a feedback-based treatment system
Am J Ophthalmol
(2009)- et al.
Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE study
Ophthalmology
(2011) Causes and prevalence of visual impairment among adults in the United States
Arch Ophthalmol
(2004)
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Financial Disclosure(s): The author(s) have made the following disclosure(s): K.B.: participated in one advisory board meeting for aflibercept for Bayer AB, Bayer Pharmaceuticals, in Sweden.
Funded by the Oslo University Hospital, Oslo, Norway. The funding organization had no role in the design of the study but aided in the conduct of the study and data management.