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Study chair details top 10 findings of CATT

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WAIKOLOA, Hawaii — The lead author of the Comparison of Age-Related Macular Degeneration Treatment Trials presented the top 10 study findings here.

“In general, physicians who use a lot of Lucentis tend to look at this data and see differences, and Avastin users tend to look at this data and see similarities,” Daniel F. Martin, MD, said at Retina 2013.

Daniel F. Martin, MD

The findings include that Lucentis (ranibizumab, Genentech) and Avastin (bevacizumab, Genentech) were equivalent in visual acuity outcomes at the conclusion of the first year of the study and that an as-needed treatment regimen of either drug produces excellent visual acuity results, albeit a mean gain of 2.4 letters less than a monthly treatment regimen.

“The bottom line is that in every piece of data I can find, these two drugs are the same for visual acuity,” Martin said.

As-needed dosing resulted in 10 fewer injections over the course of 2 years, and if a physician chooses monthly dosing for the small visual acuity benefit, then this regimen must continue indefinitely.

Martin also said almost all cases of endophthalmitis were in patients on a monthly dosing regimen.

Monthly dosing does not appear to reliably alter choroidal neovascularization anatomically, he said. There is also no evidence that three monthly injections are necessary to initiate therapy, and CATT data mandates the need for only one injection.

Monthly dosing of ranibizumab produces the greatest decrease in retinal thickness, fluid, leakage and lesion growth; however, ranibizumab monthly also produces a higher rate of very thin retinas at 1 year of treatment and a higher incidence of geographic atrophy at 2 years of treatment.

Also through 2 years of treatment, no difference was recorded between the drugs regarding rates of death, myocardial infarction or stroke.

The data showed that the specific alleles that may predict the development of AMD do not predict a patient’s response to therapy with ranibizumab or bevacizumab.

The higher price of ranibizumab over bevacizumab was also noted as a prominent finding by Martin.

Disclosure: Martin has no relevant financial disclosures.