Nearly 50% of eyes with wet age-related macular degeneration (AMD) have stable or improved vision after long-term, 8-year pro re nata (PRN) treatment with ranibizumab, according to a group of U.K. clinicians.
Further, clinical trial cohorts do not typically translate to real-world settings, and clinicians frequently modify best-practice recommendations to accommodate the reality of the clinic and the patients seen. This study had a much lower rate of attrition (45%) than other longitudinal studies, where attrition has been reported to be as high as 89%.
In this analysis, vision gains were noted through year 2, but then declined steadily, findings that are comparable to SEVEN-UP.3 There was “little difference” in the mean injection frequency that would help explain the difference in VA compared with other studies, they said.
Finally, “our cohort results could also serve as useful, relevant information in counselling neovascular AMD patients in terms of expectation in visual prognosis and driving eligibility in 8 years of anti-VEGF therapy and for practitioners to plan for future local healthcare provision.”1
Horner F, Lip PL, Clark H, Chavan R, Sarmad A, Mushtaq B. Real-World Visual And Clinical Outcomes For Patients With Neovascular Age-Related Macular Degeneration Treated With Intravitreal Ranibizumab: An 8-Year Observational Cohort (AMD8). Clin Ophthalmol 2019;13:2461-2467.
2. Jacob J, Brie H, Leys A, et al. Six-year outcomes in neovascular age-related macular degeneration with ranibizumab. Int J Ophthalmol 2017;10:81-90.
3. Rofagha S, Bhisitkul RB, Boyer DS, Sadda SR, Zhang K. Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology 2013;120:2292-9.
4. Gillies MC, Campain A, Barthelmes D, et al. Long-Term Outcomes of Treatment of Neovascular Age-Related Macular Degeneration: Data from an Observational Study. Ophthalmology 2015;122:1837-45.