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Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration

AIMS: To examine 12-month outcomes of eyes switching from intravitreal ranibizumab to aflibercept for neovascular age-related macular degeneration (nAMD). METHODS: Database observational study of eyes with nAMD tracked by the Fight Retinal Blindness outcome registry that received ranibizumab for at...

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Autores principales: Barthelmes, Daniel, Campain, Anna, Nguyen, Phuc, Arnold, Jennifer J, McAllister, Ian L, Simpson, Judy M, Hunyor, Alex P, Guymer, Robyn, Essex, Rohan W, Morlet, Nigel, Gillies, Mark C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256411/
https://www.ncbi.nlm.nih.gov/pubmed/26994110
http://dx.doi.org/10.1136/bjophthalmol-2015-308090
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author Barthelmes, Daniel
Campain, Anna
Nguyen, Phuc
Arnold, Jennifer J
McAllister, Ian L
Simpson, Judy M
Hunyor, Alex P
Guymer, Robyn
Essex, Rohan W
Morlet, Nigel
Gillies, Mark C
author_facet Barthelmes, Daniel
Campain, Anna
Nguyen, Phuc
Arnold, Jennifer J
McAllister, Ian L
Simpson, Judy M
Hunyor, Alex P
Guymer, Robyn
Essex, Rohan W
Morlet, Nigel
Gillies, Mark C
author_sort Barthelmes, Daniel
collection PubMed
description AIMS: To examine 12-month outcomes of eyes switching from intravitreal ranibizumab to aflibercept for neovascular age-related macular degeneration (nAMD). METHODS: Database observational study of eyes with nAMD tracked by the Fight Retinal Blindness outcome registry that received ranibizumab for at least 12 months before switching to aflibercept and followed for at least 12 months after the switch. Visual acuity (VA) recorded at 12 months after the switch was analysed using locally weighted scatterplot smoothing curves. Lesion activity was graded according to a prospectively identified definition. Main outcomes were change in VA and treatment intervals 12 months after the treatment switch. Secondary outcomes included change in activity grading, effect of duration of treatment before switching and analysis of eyes that switched back. RESULTS: A total of 384 eyes switched from ranibizumab to aflibercept after a mean duration of 39.8 months on the original treatment. The mean VA did not change from the time of switching treatment (63.4, SD 15.9 logarithm of the minimum angle of resolution letters) to 12 months later (63.3, SD 16.7). While 10% of eyes gained 10 or more letters 12 months after the switch, 13% lost the same amount. The mean number of injections decreased by around one injection in the 12 months after switching (p<0.001), with a decrease in the proportion of choroidal neovascular membrane lesions that were graded as active. Eyes that had been treated for the longest time (49 or more months) before switching had worse vision at the point of switch but neither change in VA nor treatment interval was different between groups. The small proportion (6.9%) of eyes that switched back again to ranibizumab had already lost a mean of 5.2 letters from the first switch to the switch back and continued to lose vision at a similar rate for at least 6 months. CONCLUSIONS: The mean VA of eyes that switched treatments from ranibizumab to aflibercept was not different 12 months later. There was a modest increase in treatment intervals and a somewhat greater proportion of eyes that were graded as inactive after the switch.
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spelling pubmed-52564112017-01-25 Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration Barthelmes, Daniel Campain, Anna Nguyen, Phuc Arnold, Jennifer J McAllister, Ian L Simpson, Judy M Hunyor, Alex P Guymer, Robyn Essex, Rohan W Morlet, Nigel Gillies, Mark C Br J Ophthalmol Clinical Science AIMS: To examine 12-month outcomes of eyes switching from intravitreal ranibizumab to aflibercept for neovascular age-related macular degeneration (nAMD). METHODS: Database observational study of eyes with nAMD tracked by the Fight Retinal Blindness outcome registry that received ranibizumab for at least 12 months before switching to aflibercept and followed for at least 12 months after the switch. Visual acuity (VA) recorded at 12 months after the switch was analysed using locally weighted scatterplot smoothing curves. Lesion activity was graded according to a prospectively identified definition. Main outcomes were change in VA and treatment intervals 12 months after the treatment switch. Secondary outcomes included change in activity grading, effect of duration of treatment before switching and analysis of eyes that switched back. RESULTS: A total of 384 eyes switched from ranibizumab to aflibercept after a mean duration of 39.8 months on the original treatment. The mean VA did not change from the time of switching treatment (63.4, SD 15.9 logarithm of the minimum angle of resolution letters) to 12 months later (63.3, SD 16.7). While 10% of eyes gained 10 or more letters 12 months after the switch, 13% lost the same amount. The mean number of injections decreased by around one injection in the 12 months after switching (p<0.001), with a decrease in the proportion of choroidal neovascular membrane lesions that were graded as active. Eyes that had been treated for the longest time (49 or more months) before switching had worse vision at the point of switch but neither change in VA nor treatment interval was different between groups. The small proportion (6.9%) of eyes that switched back again to ranibizumab had already lost a mean of 5.2 letters from the first switch to the switch back and continued to lose vision at a similar rate for at least 6 months. CONCLUSIONS: The mean VA of eyes that switched treatments from ranibizumab to aflibercept was not different 12 months later. There was a modest increase in treatment intervals and a somewhat greater proportion of eyes that were graded as inactive after the switch. BMJ Publishing Group 2016-12 2016-03-18 /pmc/articles/PMC5256411/ /pubmed/26994110 http://dx.doi.org/10.1136/bjophthalmol-2015-308090 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
spellingShingle Clinical Science
Barthelmes, Daniel
Campain, Anna
Nguyen, Phuc
Arnold, Jennifer J
McAllister, Ian L
Simpson, Judy M
Hunyor, Alex P
Guymer, Robyn
Essex, Rohan W
Morlet, Nigel
Gillies, Mark C
Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
title Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
title_full Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
title_fullStr Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
title_full_unstemmed Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
title_short Effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
title_sort effects of switching from ranibizumab to aflibercept in eyes with exudative age-related macular degeneration
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256411/
https://www.ncbi.nlm.nih.gov/pubmed/26994110
http://dx.doi.org/10.1136/bjophthalmol-2015-308090
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