Abstract
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.
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Acknowledgements
Novartis provided financial support to help the Centre for Eye Research Australia to conduct this study. The data analysis was performed independently by Datapharm, Drummoyne, New South Wales. Novartis had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
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Presented in part at the 40th Annual Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists, Melbourne, Australia, 2008
Financial disclosure: K Michalova's and S Wickremasinghe's fellowships at the Centre for Eye Research Australia were supported by Novartis. RH Guymer, CA Harper, and AP Hunyor are on the medical retina advisory board of Novartis Australia. RH Guymer and A Chang were principal investigators in Novartis-sponsored trials in AMD.
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Michalova, K., Wickremasinghe, S., Tan, T. et al. Ranibizumab treatment for neovascular age-related macular degeneration: from randomized trials to clinical practice. Eye 23, 1633–1640 (2009). https://doi.org/10.1038/eye.2009.175
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DOI: https://doi.org/10.1038/eye.2009.175
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