November 12, 2012
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Speaker reviews study results of various anti-VEGF treatments for wet AMD

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CHICAGO — Results of the most recent comparison studies offer a plethora of information for clinicians to use in treating neovascular age-related macular degeneration, a speaker said here.

During Retina Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia-Pacific Academy of Ophthalmology, Peter K. Kaiser, MD, shared pearls on how to apply results of the CATT, IVAN, VIEW, MANTA and HARBOR studies in everyday clinical practice.

The studies compared various combinations and monotherapies of Lucentis (ranibizumab, Genentech), Avastin (bevacizumab, Genentech) and Eylea (aflibercept, Regeneron).

“You can interpret the results of those clinical studies any way you want based on your particular baseline bias,” Kaiser said.

Aflibercept emerged as the “winner” in the studies, Kaiser said. The safety and efficacy of aflibercept was comparable to that of monthly ranibizumab, he said. In addition, fewer treatments were needed with aflibercept compared with ranibizumab.

“In the patients who needed a lot of injections in the second year, they were more likely to be in the Lucentis groups than in the Eylea groups,” Kaiser said. “So, I like Eylea better.”

One-year data from the CATT showed that ranibizumab and bevacizumab were non-inferior in terms of mean change in visual acuity when dosed monthly. The results did not show differences in terms of safety, Kaiser said.

Study results showed that ranibizumab required fewer injections than bevacizumab, Kaiser said.

“I like a dry retina, and Lucentis dries faster,” he said. “So, in the first month, you already saw a difference between the Lucentis and Avastin groups in terms of drying of the retina. This persisted after 24 months, where the patients who received Lucentis monthly had the driest retinas, and that’s what I like to see.”

Disclosure: Kaiser is a consultant for Alcon, ArcticDx, Bayer, Genentech, Novartis, Regeneron and SKS Ocular, receives grant support from Genentech, Novartis and Regeneron, and is equity owner of SKS Ocular.