If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  Single Re-treatment Injection of Ranibizumab, Bevacizumab Not Sufficient to Recover Lost Visual Acuity in AMD: Presented at RC2009 By Cameron Johnston NEW YORK -- October 5, 2009 -- Not all patients with age-related macular degeneration (AMD) who are treated with antiangiogenic agents will show the same response profiles. Some may regress and lose visual acuity (VA), while others maintain their improved VA over many months. The question of what to do when a patient gains and then subsequently loses VA has not been fully answered, although according to a study presented here on October 2 at the Retina Congress (RC) 2009, the outcome of re-treatments may depend upon how quickly the patient loses VA. According to Frank Holz MD, University of Bonn, Bonn, Germany, it is an accepted rule of thumb that when a patient is being treated with a drug like ranibizumab or bevacizumab, re-treatment should be given when a loss of 5 or more ETDRS letters is observed. However, he said, the patient’s response to this re-treatment may depend on how quickly the patient loses the 5 letters in the first place. As part of a larger study, 513 patients with neovascular AMD were treated with ranibizumab in 3 monthly loading doses (induction phase), followed by as-needed re-treatment. Following the induction phase, 225 patients lost at least 5 letters in VA, and received a total of 651 additional injections of ranibizumab. A considerable difference in response to re-treatment was seen depending on how quickly the patient lost VA and when he or she received the re-treatment. For example, when a loss in VA of 10.32 ETDRS letters occurred abruptly over a 1-month period, the mean amount of VA that was recovered was 5.07 letters following a single injection of ranibizumab. However, when a loss of 8.5 letters in VA was recorded over 2 months and re-treatment was given, the amount recovered was only 1.74 letters. When a loss in VA of 8.05 letters was observed over 5 months, the amount recovered was 1.2 letters. Overall, patients in the study experienced a mean loss in VA of 9.21 letters before re-treatment was initiated. The mean amount of VA that was recovered was only 2.67 letters. According to Dr. Holz, this indicates the importance of monthly monitoring for these patients, so if there is a loss in VA, it can be detected early, and re-treatment be initiated as quickly as possible. This would, in effect, help maximise any potential benefit from re-treatment. Funding for this study was provided by Novartis. The 2009 Retina Congress is a combined meeting of the American Society of Retina Specialists, the Macula Society, and the Retina Society. [Presentation title: Visual Acuity Recovery After a Single Ranibizumab Re-Treatment in Patients of the SUSTAIN Study During PRN Treatment. Poster 727]
|
