Study finds higher than expected response rate from pegaptanib against CNV

Using pegaptanib as a primary treatment for choroidal neovascularization secondary to age-related macular degeneration may result in better visual outcomes than those reported in previous clinical trials of the drug, a retrospective study suggests. Among eyes that had received no prior AMD treatment, 90% had an improvement or stabilization of vision, the study authors reported.

Polly A. Quiram, MD, PhD, and colleagues reviewed outcomes for 90 newly diagnosed exudative AMD patients treated with Macugen (pegaptanib sodium, OSI Eyetech Pharmaceuticals) for previously untreated choroidal neovascular membranes. Of these patients, 72 (80%) had occult lesions, 12 (13%) had minimally classic lesions and six (7%) had predominantly classic lesions. Additionally, 45 lesions (50%) were four disc areas or less in size and 45 (50%) were more than four disc areas in size, according to the study.

Patients received pegaptanib injections at 6-week intervals. Investigators performed fluorescein angiography and optical coherence tomography imaging after every third injection.

Overall, 90% of patients had responded to pegaptanib treatment at 9.1 months mean follow-up. Specifically, 18 patients (20%) gained three or more lines of vision, and vision stabilized in 63 patients (70%), which the authors defined as the prevention of a loss of three lines of vision, according to the study.

Patients who gained three or more lines of vision received an average of 3.5 injections, the authors noted.

Nine patients (10%) lost three or more lines of vision, and one patient developed endophthalmitis, they added.

"Pegaptanib as primary therapy for naive CNV lesions offers a 90% rate of improvement or stabilization of vision-outcomes that exceed those reported in the [VEGF Inhibition Study in Ocular Neovascularization] trial," the authors said.

The study is published in the September issue of Retina.