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Speaker: Individualized care for patients with AMD best for results

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WAILEA, Hawaii – The most significant lesson learned from the HARBOR study is that individualization of patient care achieves best results when it comes to the treatment of age-related macular degeneration, a presenter said here.

Pravin U.
Dugel

“Simply treating all patients the same is not good medicine,” Pravin U. Dugel, MD,said at Retina 2015.

In the HARBOR study, patients with age-related macular degeneration experienced clinically meaningful and similar improvement in visual and anatomic outcomes over 2 years, regardless of dosing regimen with ranibizumab (Lucentis, Genentech). Both monthly and PRN treatment provided rapid and sustained anatomic response, Dugel said. Furthermore, in patients with pigment epithelium detachment (PED) at baseline, vision improved regardless of PED size, treatment regimen or dose, Dugel said.

“I consider this the most relevant level 1 study that we have,” Dugel said, basing his statement on the premise that HARBOR was the first study to use SD-OCT to follow disease and he believes the first study to incorporate PEDs in its retreatment criteria.

Dugel said that some patients in the HARBOR trial were delayed vision gainers, with approximately one-third of patients gaining vision slowly, and that 93% of patients did not need monthly treatments.

“There may be a group of patients where we have to keep on treating to achieve the vision results that we want,” Dugel said.

Ranibiuzumab-treated patients do not need monthly treatments, Dugel said. “Ninety-three percent of patients did not need monthly treatments,” he said.

“The best treatment is individualizing your treatment,” Dugel said, “because clearly these patients are different.” – by Patricia Nale

Disclosure: Dugel reports being a consultant for Genentech, Novartis and Regeneron.