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Ranibizumab and Bevacizumab for Neovascular Age-Related Macular Degeneration



Abstract

OBJECTIVE:  In the randomized Comparison of Age-Related Macular Degeneration Treatments Trials (CATT), the researchers set out to assess the relative efficacy and safety of ranibizumab and bevacizumab and to determine whether an as-needed regimen would compromise long-term visual acuity, as compared with a monthly regimen

METHODS: A copy of the protocol and the statistical analysis plan (in the Supplementary Appendix) are available with the full text of this article at NEJM.org

RESULTS: A statistically significant improvement was observed in many clinical and instrumental parameters investigated (P < 0.001). In particular, improvement of skin redness, papules, itching, hydration, and skin color occurred.

CONCLUSIONS: Visual acuity improved from baseline to 1 year in all four study groups. Most of the improvement occurred during the first 6 months (Figure 2AFIGURE 2Change in Visual-Acuity Score from Baseline to 1 Year.). At 1 year, bevacizumab was equivalent to ranibizumab (99.2% confidence interval for the difference in the mean change in visual-acuity score within −5 to +5 letters) both when the drugs were given monthly and when the drugs were given as needed (Figure 2B). Ranibizumab given as needed was equivalent to ranibizumab given monthly. The comparison between bevacizumab given as needed and bevacizumab given monthly was inconclusive, so neither noninferiority nor inferiority was established between the two study groups. Ranibizumab given as needed was equivalent to bevacizumab given monthly. The comparison between bevacizumab given as needed and ranibizumab given monthly was also inconclusive.

Full Article (Free) New England Journal of Medicine, April 28, 2011, "Ranibizumab and Bevacizumab for Neovascular Age-Related Macular Degeneration"

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