Treat and Extend versus Pro Re Nata regimens of ranibizumab in neovascular age-related macular degeneration: a comparative 12 Month study.

Abstract

To compare outcomes in patients with treatment-naïve neovascular age-related macular degeneration (nAMD) receiving ranibizumab treat and extend (TE) with those receiving ranibizumab pro re nata (PRN) in a clinical setting. During this 12-month retrospective, consecutive, comparative case series, patients received ranibizumab 0.5mg according to a TE or PRN regimen. Monthly optical coherence tomography (OCT) evaluation was performed during the PRN regimen; retreatment criteria included recurrence of intra-/subretinal fluid, or haemorrhages. During the TE regimen, initial treatment with 4-week intervals was sequentially lengthened by 2weeks until signs of choroidal neovascularization (CNV) activity recurred. Study end-points included mean change in best corrected visual acuity (BCVA) and central retinal thickness (CRT), mean injection frequency and number of follow-up visits attended. Baseline characteristics were similar between the TE (n=70) and PRN (n=70) groups. Mean change in BCVA from baseline to Month 12 was significantly greater in the TE group than the PRN group (+0.18±0.17 versus +0.07±0.20, p<0.001). Mean change in CRT from baseline to Month 12 was greater in the TE group than the PRN group (-116±132 versus -58±157μm, p=0.019). The number of follow-up visits attended was significantly higher in the PRN group than the TE group (11.9±1.1 versus 8.6±1.9, p<0.001), while patients in the TE group received more injections during the study than those in the PRN group (8.6±1.9 versus 6.0±1.9, p<0.001). Ranibizumab administered using a TE regimen in treatment-naïve patients with nAMD provided better visual outcomes with fewer clinic visits, compared with a PRN regimen.