학술논문
A Real-World, Multicenter, 6-Month Prospective Study in Greece of the Effectiveness and Safety of Ranibizumab in Patients with Age-Related Macular Degeneration Who Have Inadequately Responded to Aflibercept: The 'ELEVATE' Study
ORIGINAL RESEARCH
ORIGINAL RESEARCH
Document Type
Clinical report
Author
Source
Clinical Ophthalmology. August 31, 2022, Vol. 16, p2579, 15 p.
Subject
Language
English
ISSN
1177-5483
Abstract
Introduction Age-related macular degeneration (AMD) is a progressive, degenerative disease of the retina, and a leading cause of vision loss worldwide. (1) It is estimated that in 2020, 196 million [...]
Purpose: Real-world evidence on short-term outcomes of ranibizumab in wet age-related macular degeneration (wAMD) following inadequate response to aflibercept is scarce. This study aimed to evaluate the functional and anatomic effects of switching to ranibizumab in cases of wAMD previously treated with aflibercept with inadequate response. Patients and Methods: Prospective, observational study performed in eight ophthalmology hospital/private clinics in Greece, enrolling consented patients with active wAMD, >50 years-old, who had initiated ranibizumab >28 days and Results: Between September-2015 and November-2017, 103 eligible patients (56.3% females; mean age: 74.8[+ or -]8.6 years) were consecutively enrolled. The age at AMD diagnosis in the study eye was 71.3[+ or -]8.8 years. Aflibercept (median of 5 injections received over 11.3 months) had been discontinued for anatomical (in 69.9%) and/or functional (38.8%) reasons. At baseline (median: 24.3 months after wAMD diagnosis), choroidal neovascularization was occult in 69.1% of evaluable study eyes; 60.2% of the study eyes had pigment epithelial detachment (PED); 42.7% cysts; 21.4% fibrosis; 66.0% subretinal, and 59.2% intraretinal fluid. At 6 months post-baseline: a median of 3 ranibizumab injections (range: 1-6) had been received; the best-corrected visual acuity (BCVA)>0 letter gain rate was 81.8%; the BCVA >15 letter gain rate was 17.0%; BCVA gain was 3.2 letters [mean increase: 3.2[+ or -]10.0 letters; median: 0.0; p = 0.002]; PED greatest basal diameter (GBD; median: 1470.5 [micro]m) also decreased (median decrease: 114.0 [micro]m; p = 0.019). Baseline central retinal thickness (CRT; median: 312.0 [micro]m) remained unchanged. One patient permanently discontinued ranibizumab due to adverse event occurrence, assessed as not causally related to ranibizumab. There were no ranibizumab-related adverse reactions. Conclusion: Six-month treatment with ranibizumab in aflibercept inadequate responders led to visual acuity and PED GBD improvements, with no statistically significant CRT change. Keywords: best corrected visual acuity, central retinal thickness, pigment epithelial detachment
Purpose: Real-world evidence on short-term outcomes of ranibizumab in wet age-related macular degeneration (wAMD) following inadequate response to aflibercept is scarce. This study aimed to evaluate the functional and anatomic effects of switching to ranibizumab in cases of wAMD previously treated with aflibercept with inadequate response. Patients and Methods: Prospective, observational study performed in eight ophthalmology hospital/private clinics in Greece, enrolling consented patients with active wAMD, >50 years-old, who had initiated ranibizumab >28 days and Results: Between September-2015 and November-2017, 103 eligible patients (56.3% females; mean age: 74.8[+ or -]8.6 years) were consecutively enrolled. The age at AMD diagnosis in the study eye was 71.3[+ or -]8.8 years. Aflibercept (median of 5 injections received over 11.3 months) had been discontinued for anatomical (in 69.9%) and/or functional (38.8%) reasons. At baseline (median: 24.3 months after wAMD diagnosis), choroidal neovascularization was occult in 69.1% of evaluable study eyes; 60.2% of the study eyes had pigment epithelial detachment (PED); 42.7% cysts; 21.4% fibrosis; 66.0% subretinal, and 59.2% intraretinal fluid. At 6 months post-baseline: a median of 3 ranibizumab injections (range: 1-6) had been received; the best-corrected visual acuity (BCVA)>0 letter gain rate was 81.8%; the BCVA >15 letter gain rate was 17.0%; BCVA gain was 3.2 letters [mean increase: 3.2[+ or -]10.0 letters; median: 0.0; p = 0.002]; PED greatest basal diameter (GBD; median: 1470.5 [micro]m) also decreased (median decrease: 114.0 [micro]m; p = 0.019). Baseline central retinal thickness (CRT; median: 312.0 [micro]m) remained unchanged. One patient permanently discontinued ranibizumab due to adverse event occurrence, assessed as not causally related to ranibizumab. There were no ranibizumab-related adverse reactions. Conclusion: Six-month treatment with ranibizumab in aflibercept inadequate responders led to visual acuity and PED GBD improvements, with no statistically significant CRT change. Keywords: best corrected visual acuity, central retinal thickness, pigment epithelial detachment