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Combination PDT, ranibizumab more effective against CNV than monotherapy
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FORT LAUDERDALE, Fla. — Combination treatment with photodynamic therapy and intravitreal ranibizumab requires fewer re-treatment injections against subfoveal choroidal neovascularization than ranibizumab alone, according to a speaker here at the Association for Research in Vision and Ophthalmology meeting.
"You need significantly less re-injections if you combine PDT with Lucentis (ranibizumab, Genentech), but the timing of re-injection is still unpredictable," Beatrice Braun, MD, told Ocular Surgery News in an interview after her presentation. "We still have to investigate the patients monthly to maintain the initial gain of visual acuity after the initial three doses."
Dr. Braun and colleagues at University Eye Hospital in Basel, Switzerland are conducting the ongoing randomized, controlled trial comparing the ranibizumab monotherapy with combination therapy using standard fluence PDT and ranibizumab. Of the 37 patients who completed the trial, 19 were given monotherapy and 18 had the combination therapy.
Patients were randomly assigned to receive initial PDT or sham PDT, followed by three initial monthly 0.3-mg intravitreal ranibizumab injections. Patients who suffered a loss of more than five letters of best corrected visual acuity or an increase in central retinal thickness more than 100 µm, as shown on optical coherence tomography, received additional injections as needed.
During the first 6 months of the study, 29.7% of all patients needed re-injections — 42.1% in the monotherapy group and 16.7% in the combination group. Neither group showed a significant difference in re-treatment indications.