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. 2016 Jan;123(1):70-77.e1.
doi: 10.1016/j.ophtha.2015.09.002. Epub 2015 Oct 21.

Intravitreal Bevacizumab Versus Ranibizumab for Treatment of Neovascular Age-Related Macular Degeneration: Findings from a Cochrane Systematic Review

Sharon D Solomon  1 , Kristina B Lindsley  2 , Magdalena G Krzystolik  3 , Satyanarayana S Vedula  4 , Barbara S Hawkins  5
Affiliations

Intravitreal Bevacizumab Versus Ranibizumab for Treatment of Neovascular Age-Related Macular Degeneration: Findings from a Cochrane Systematic Review

Sharon D Solomon et al. Ophthalmology. 2016 Jan.

Abstract

Topic: To summarize the relative effects of bevacizumab (Avastin; Genentech, Inc, South San Francisco, CA) and ranibizumab (Lucentis; Genentech, Inc.), using findings from a Cochrane Eyes and Vision Group systematic review.

Clinical relevance: Neovascular age-related macular degeneration (NVAMD) is the most common cause of uncorrectable vision loss among the elderly in developed countries. Bevacizumab and ranibizumab are the most frequently used anti-vascular endothelial growth factor (VEGF) agents injected intravitreally to treat NVAMD.

Methods: For this systematic review, we included only randomized controlled trials in which the 2 anti-VEGF agents had been compared directly. The primary outcome was 1-year gain in best-corrected visual acuity (BCVA) of ≥15 letters. We followed Cochrane methods for trial selection, data extraction, and data analyses. Relative effects of bevacizumab versus ranibizumab are presented as estimated risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).

Results: We identified 6 eligible randomized controlled trials with 2809 participants. The proportion of eyes that gained ≥15 letters of BCVA by 1 year was similar for the 2 agents when the same regimens were compared (RR, 0.90; 95% CI, 0.73-1.11). The mean change in BCVA from baseline also was similar (MD, -0.5 letter; 95% CI, -1.6 to +0.6). Other BCVA and quality of life outcomes were similar for the 2 agents. One-year treatment cost with ranibizumab was 5.1 and 25.5 times the cost for bevacizumab in the 2 largest trials. Ocular adverse events were uncommon (<1%), and rates were similar for the 2 agents.

Conclusions: We found no important difference in effectiveness or safety between bevacizumab and ranibizumab for NVAMD treatment, but there was a large cost difference.

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Figures

Figure 1
Figure 1
Identification and selection of trials that had compared bevacizumab with ranibizumab for any outcome targeted for the systematic review.
Figure 2
Figure 2
Risk of bias for individual trials by domain assessed. Green, low risk of bias; yellow, unclear/unknown risk of bias; red, high risk of bias.
Figure 3
Figure 3
Forest plot showing estimated risk ratios with their 95% confidence intervals for bevacizumab versus ranibizumab for gain of 15 of more letters from baseline, for each of the 6 individual trials and combined. Part a: One-year findings. Part b. Two-year findings.
Figure 3
Figure 3
Forest plot showing estimated risk ratios with their 95% confidence intervals for bevacizumab versus ranibizumab for gain of 15 of more letters from baseline, for each of the 6 individual trials and combined. Part a: One-year findings. Part b. Two-year findings.
See this image and copyright information in PMC

References

    1. Gragoudas ES, Adamis AP, Cunningham ET, et al. Pegaptanib for neovascular age-related macular degeneration. N Engl J Med. 2004;351:2805–16. - PubMed
    1. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–31. - PubMed
    1. Brown DM, Kaiser PK, Michels M, et al. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1432–1444. - PubMed
    1. Vedula SS, Krzystolik M. Antiangiogenic therapy with anti-vascular endothelial growth factor modalities for neovascular age-related macular degeneration. Cochrane Database of Systematic Reviews. 2008;(2) Art. No.: CD005139. DOI: 10.1002/14681858.CD005139.pub2. - PMC - PubMed
    1. Solomon SD, Lindsley K, Vedula SS, et al. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Database of Systematic Reviews. 2014;(8) Art. No.:CD005139. DOI: 10.1002/14671858.CD005139.pub3. - PMC - PubMed

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