Bevacizumab in age-related macular degeneration: a randomized controlled trial on the effect of injections every 4 weeks, 6 weeks and 8 weeks

Acta Ophthalmol. 2013 Sep;91(6):e456-61. doi: 10.1111/aos.12119. Epub 2013 Jun 15.

Abstract

Purpose: Several clinical trials have established the efficacy of ranibizumab therapy administered every 4 weeks to treat exudative age-related macular degeneration (ARMD). Bevacizumab appears to be a cost-effective alternative to ranibizumab, although an optimal injection schedule has not yet been determined. In this study, we set out to determine whether bevacizumab treatment in exudative ARMD every 6 or 8 weeks is non-inferior to bevacizumab treatment every 4 weeks.

Methods: A total of 191 patients with exudative ARMD were randomly assigned to a 1-year continuous regimen of intravitreal bevacizumab every 4 (n = 64), 6 (n = 63) or 8 weeks (n = 64). The primary outcome was visual acuity change after 1 year of treatment.

Results: In all three treatment groups, visual acuity improved between baseline and 1 year. There was no statistically significant difference in the mean change of visual acuity score at 1 year for bevacizumab administered every 4 (1.96 ± 13.70), 6 (1.60 ± 10.98) or 8 weeks (5.98 ± 8.88). Reduction in central retinal thickness was observed in all three study groups. At 1 year, the mean decrease in central foveal thickness ranged from 86 ± 97 μm in the every 6 weeks group to 109 ± 90 μm in the group every 8 weeks group (p = 0.30).

Conclusion: At 1 year, bevacizumab administered every 6 or 8 weeks was not inferior to therapy administered every 4 weeks.

Keywords: age-related macular degeneration; anti-vascular endothelial growth factor; bevacizumab; treatment.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Angiogenesis Inhibitors / adverse effects
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Bevacizumab
  • Drug Administration Schedule
  • Exudates and Transudates
  • Female
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Male
  • Prospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology
  • Wet Macular Degeneration / diagnosis
  • Wet Macular Degeneration / drug therapy*
  • Wet Macular Degeneration / physiopathology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab