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Minimal differences seen in yearly number of injections and cost for ranibizumab, aflibercept
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ORLANDO, Fla. — Differences between ranibizumab and aflibercept for treatment of neovascular age-related macular degeneration were minimal in annual injection frequency, costs and number of ophthalmologist visits, according to a study presented at the Association for Research in Vision and Ophthalmology meeting.
Furthermore, a higher rate of endophthalmitis was associated with aflibercept injections, Szilárd Kiss, MD, and colleagues said in the poster.
“In the real-world setting, in regard to first-line treatment, whether you have been using anti-VEGFs or you are switching, there really is no major difference between Lucentis and Eylea in terms of injection frequency, costs and annual visits to an ophthalmologist,” Kiss told Ocular Surgery News.
The retrospective cohort study included 1,201 patients identified from Medicare databases from November 2011 through July 2013; 912 patients received Lucentis (ranibizumab, Genentech) injections and 289 patients received Eylea (aflibercept, Regeneron) injections as first- or second-line treatment.
Four hundred eighty-one patients received ranibizumab and 115 patients received aflibercept as first-line treatment, and 431 patients received ranibizumab and 174 patients received aflibercept as second-line treatment.
In first-line ranibizumab treatment, mean number of doses given per year was 5.02, annual cost was $9,894 and mean number of ophthalmologist visits was 6.08, compared with first-line aflibercept treatment at 5.04 doses, $10,288 and 5.24 annual visits. Second-line ranibizumab treatment was 5.76 mean doses, $12,173 and 5.79 annual visits, compared with second-line aflibercept treatment at 5.72 doses $11,109 and 5.62 annual visits.
In a separate study, authors analyzed 824,465 injections in 157,106 patients with AMD and found that endophthalmitis developed after 775 injections.
“The overall rate [of endophthalmitis] is what we have seen in clinical trials, which is 0.09%. It is sort of nice to know that whether it is a clinical trial setting or a clinical practice that it is about the same. However, if you look at the difference between Lucentis and Eylea, we found a significant difference,” Kiss said.
Endophthalmitis occurred in 158 patients after 202,225 injections of ranibizumab compared with 238 patients after 136,821 injections of aflibercept.
Disclosure: Kiss is a consultant for Allergan, Alimera, Alcon, Genentech, Regeneron and Optos, and has received research funding from Allergan, Alimera, Genentech, Regeneron and Optos.