Journal
OPHTHALMOLOGY
Volume 123, Issue 1, Pages 70-+Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ophtha.2015.09.002
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Funding
- Cochrane Eyes and Vision Group US Project [U01 EY-020522]
- National Eye Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, Maryland
- Research to Prevent Blindness, New York, New York
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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. 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. (C) 2016 by the American Academy of Ophthalmology.
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