Date Posted: 04 March 2010
A study comparing the use of bevacizumab (marketed as Avastin) and ranibizumab (marketed as Lucentis) has shown that the two "wet" AMD treatments are equally effective at halting vision loss. The study, conducted by Dr. Donald S. Fong of the Kaiser Permanente Southern California Medical Group, compared the visual acuity among 324 newly diagnosed AMD patients treated with bevacizumab with 128 AMD patients treated with ranibizumab. The findings demonstrated that patients with a 20/40 vision or better increased from 13.6% to 22.9% in bevacizumab patients and from 11.7% to 25.0% in ranibizumab patients.
The findings anticipate a far larger randomized study entitled, "Comparisons of Age Related Macular Degeneration Treatment Trials" (CATT), which is scheduled to report its first results in early 2011. The CATT trial, sponsored by the NEI, is a multicentre trial designed to assess the safety and efficacy of Avastin and Lucentis for patients undergoing treatment for wet AMD and the trial will have a primary outcome measure of mean visual acuity over a 12-month period.
In the present study published in the journal Ophthalmology, the Kaiser Permanente team found that comparisons in the mean visual acuity, changes in visual acuity and visual acuity loss/gain showed "no great differences between the 2 agents [bevacizumab and ranibizumab]". The authors reported a number of strengths and weaknesses in the study. The strengths included a large sample size and a long follow up time in addition to the fact that there were no financial incentives for physicians to use one drug or another and the patients (all being members of Kaiser permanent's plan) had no copay differences. Weaknesses of the study were that it was an observational study only and treatment assignment had not being randomized. Also, there was no standardised protocol to guide injection frequencies and, as such, interpretations of the data should accommodate these variations. In summary, the authors concluded that both bevacizumab and ranibizumab appeared to be effective in reducing visual acuity loss but that the CATT trial is likely to deliver more definitive information. [Fong et al, Ophthalmology 2010;117:298 â€"302].
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