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How many injections of ranibizumab are necessary in the first year of wet AMD treatment? A meta-analysis

Session Details

Session Title: AMD II

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 08:24

Venue: Boulevard D

First Author: : H.Gerding SWITZERLAND

Co Author(s): :                  

Abstract Details

Purpose:

Although ranibizumab is widely used in age-related macular degeneration there is so far no systematic analysis available on the relation between injection frequency and functional efficacy within the first 12 months of treatment.

Setting:

Meta-analysis on available Medline literature.

Methods:

47 relevant clinical studies (54 case series) could be identified covering 11.706 treated eyes. Non-linear and linear regression was calculated for the relation between treatment frequency and functional outcome (average gain in visual acuity, % of eyes losing less than 15 letters of visual acuity, % of eyes gaining ≥15 letters) within the first year of care.

Results:

Mean improvement of average visual gain was +4.9 +/- 3.6 (mean +/- 1 standard deviation) letters (case-weighted: 3.3 letters). The average number of ranibizumab injections until month 12 was 6.3 +/-2.0 (case-weighted: 5.9). 92.4 +/- 3.9 % of eyes (case-weighted: 91.9 %) lost less than three lines of visual acuity and 24.5 +/- 8.2 % (case-weighted: 23.3) gained more than 3 lines within the first year. Analysis of the relation between the number of injections and functional improvement indicated best fit for non-linear equations. A nearly stepwise improvement of functional gain occurred between 6.8 and 7.2 injections/year. A saturation effect of treatment occurred beyond this level of injection frequency.

Conclusions:

The results of this meta-analysis clearly indicate a non-linear relation between the number of injections and functional gain of ranibizumab within the first 12 months of treatment. Treatment saturation seems to occur at a treatment frequency >7.2 injections within the first 12 months.

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