TY - JOUR
T1 - Bevacizumab in age-related macular degeneration
T2 - a randomized controlled trial on the effect of on-demand therapy every 4 or 8 weeks
AU - Amarakoon, Sankha
AU - Martinez-Ciriano, José P
AU - van den Born, L Ingeborgh
AU - Baarsma, Seerp
AU - Missotten, Tom
N1 - © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2019/2
Y1 - 2019/2
N2 - PURPOSE: Intravitreal anti-vascular endothelial growth factor (VEGF) injections are an effective treatment for neovascular age-related macular degeneration (nARMD). Bevacizumab appears to be a cost-effective off-label anti-VEGF alternative to ranibizumab, but an optimal injection schedule has not yet been determined. In this study, we investigate whether on-demand bevacizumab treatment every 8 weeks is non-inferior to on-demand bevacizumab every 4 weeks in treating nARMD.METHODS: A total of 120 nARMD patients were randomly assigned to an on-demand regimen of intravitreal bevacizumab (IVB) every 4 (n = 60) or 8 weeks (n = 60). The primary outcome was visual acuity (VA) change after 1 year of treatment.RESULTS: Visual acuity (VA) improved between baseline and 1 year in both treatment groups. The mean change in the VA score at 1 year was not significantly different between bevacizumab administration on-demand every 4 weeks [5.6 ± 10.2 Early Treatment Diabetic Retinopathy Study (ETDRS) letter] or 8 weeks (4.6 ± 12.0 ETDRS letters). A reduction in the central retinal thickness was observed in both groups. At 1 year, the mean decrease in central foveal thickness ranged from 61 ± 90 μm in the 4-week group to 91 ± 83 μm in the 8-week group (p = 0.07). The mean number of IVB treatments during the study period was 8.7 ± 2.3 in the 4-week group and 5.9 ± 1.0 in the 8-week group.CONCLUSION: At 1 year, bevacizumab administration on-demand every 8 weeks was non-inferior to administration every 4 weeks. The results strongly suggest that bevacizumab acts longer than 4 weeks in ARMD, reducing the burden of injections for patients.
AB - PURPOSE: Intravitreal anti-vascular endothelial growth factor (VEGF) injections are an effective treatment for neovascular age-related macular degeneration (nARMD). Bevacizumab appears to be a cost-effective off-label anti-VEGF alternative to ranibizumab, but an optimal injection schedule has not yet been determined. In this study, we investigate whether on-demand bevacizumab treatment every 8 weeks is non-inferior to on-demand bevacizumab every 4 weeks in treating nARMD.METHODS: A total of 120 nARMD patients were randomly assigned to an on-demand regimen of intravitreal bevacizumab (IVB) every 4 (n = 60) or 8 weeks (n = 60). The primary outcome was visual acuity (VA) change after 1 year of treatment.RESULTS: Visual acuity (VA) improved between baseline and 1 year in both treatment groups. The mean change in the VA score at 1 year was not significantly different between bevacizumab administration on-demand every 4 weeks [5.6 ± 10.2 Early Treatment Diabetic Retinopathy Study (ETDRS) letter] or 8 weeks (4.6 ± 12.0 ETDRS letters). A reduction in the central retinal thickness was observed in both groups. At 1 year, the mean decrease in central foveal thickness ranged from 61 ± 90 μm in the 4-week group to 91 ± 83 μm in the 8-week group (p = 0.07). The mean number of IVB treatments during the study period was 8.7 ± 2.3 in the 4-week group and 5.9 ± 1.0 in the 8-week group.CONCLUSION: At 1 year, bevacizumab administration on-demand every 8 weeks was non-inferior to administration every 4 weeks. The results strongly suggest that bevacizumab acts longer than 4 weeks in ARMD, reducing the burden of injections for patients.
KW - Aged
KW - Aged, 80 and over
KW - Angiogenesis Inhibitors/administration & dosage
KW - Bevacizumab/administration & dosage
KW - Dose-Response Relationship, Drug
KW - Female
KW - Fluorescein Angiography
KW - Follow-Up Studies
KW - Fundus Oculi
KW - Humans
KW - Intravitreal Injections
KW - Macular Degeneration/diagnosis
KW - Male
KW - Prospective Studies
KW - Time Factors
KW - Tomography, Optical Coherence
KW - Treatment Outcome
KW - Vascular Endothelial Growth Factor A/antagonists & inhibitors
KW - Visual Acuity
U2 - 10.1111/aos.13774
DO - 10.1111/aos.13774
M3 - Article
C2 - 30369062
SN - 1755-375X
VL - 97
SP - 107
EP - 112
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
IS - 1
ER -