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Treat-and-extend with ranibizumab comparable to monthly treatment for wet AMD

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Peter Kertes

VANCOUVER, British Columbia — A 24-month treat-and-extend analysis trial with ranibizumab for patients with neovascular age-related macular degeneration showed statistically significant improvements in best corrected visual acuity at 12 months compared with a monthly dosing regimen, according to a speaker here.

“Treat-and-extend induces significantly higher visual acuity improvement at 12 months compared to monthly administration and comparable improvement at 24 months, but with fewer visits and fewer injections,” Peter Kertes, MD, FRCS(C), said at the American Society of Retina Specialists annual meeting.

The 24-month randomized, open-label Canadian treat-and-extend trial (CANTREAT) included 580 neovascular AMD patients randomized 1:1 to a monthly or treat-and-extend injection therapy of ranibizumab, Kertes said.

At 12 months, patients in the treat-and-extend group experienced a mean 8.4 letter BCVA improvement, compared to 6 letter BCVA improvement in the monthly group, a statistically significant difference (P = .009). At 24-month follow up, the mean BCVA improvement in the treat-and-extend group was 6.5 letters, compared to 6.1 letters in the monthly treatment group, he said.

Treat-and-extend group patients underwent a statistically significant fewer number of injections over the 24-month study compared with the monthly treatment group. At 12 months, the treat and extend group underwent 9.4 injections, compared to 11.8 injections for the monthly group (P < .001). At 24 months, treat-and-extend patients underwent 17.7 injections, compared with 23.6 injections in the monthly group (P < .001).

“In a real-world setting, despite fewer visits and ranibizumab injections, the treat-and-extend regimen allows for clinically meaningful improvements in best corrected visual acuity,” he said. – by Robert Linnehan

Reference: Kertes P. Canadian Treat-and-Extend Analysis Trial with Ranibizumab in patients with Neovascular AMD CANTREAT Study 1-year results. Presented at: American Society of Retina Specialists annual meeting; July 20-25, 2018; Vancouver, British Columbia.

Disclosure: Kertes reports receiving research funding from Bayer, Allergan, Alcon, Novartis, Roche and Genentech. He reports having sat on advisory boards for Novartis, Alcon, and Bayer. He reports receiving travel grants from Novartis and Bayer. He reports owning stock in Arctic Dx.