Ranibizumab (Genentech, South San Francisco, CA, USA) was a revolutionary anti-VEGF molecule approved by FDA in 2006 for neovascular age-related macular degeneration (nAMD). It had a paradigm-shifting effect on the treatment of various retinal neovascular pathologies, especially in nAMD and diabetic macular oedema (DME) [1, 2]. Ranibizumab monthly dose regimen has brought down the blindness attributable to nAMD by 72% and thus has provided a new lease of functional and quality life to the patients [2].

Since the introduction, except for a biosimilar that was approved for the Indian market, there has not been any advancement for the molecule per se [3]. The dosing, the delivery system, and the efficacy and safety have all been stagnant for the last 13 years [1]. In 2016 and 2018, the FDA had approved pre-filled syringes for ranibizumab in 0.5 mg dose and 0.3 mg dose, which was the first improvement in the delivery system since its launch [1]. Multiple trials have provided us with some guidelines such as monthly, pro re nata (PRN) and Treat and Extend (TREX). However, they all have a common denominator of being multiple injections regimen [4,5,6].

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