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Previous Volume 355:1419-1431 October 5, 2006 Number 14 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Steinbrook, R. Editorial by Stone, E. M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Ranibizumab — a recombinant, humanized, monoclonal antibody Fab that neutralizes all active forms of vascular endothelial growth factor A — has been evaluated for the treatment of neovascular age-related macular degeneration.

Methods In this multicenter, 2-year, double-blind, sham-controlled study, we randomly assigned patients with age-related macular degeneration with either minimally classic or occult (with no classic lesions) choroidal neovascularization to receive 24 monthly intravitreal injections of ranibizumab (either 0.3 mg or 0.5 mg) or sham injections. The primary end point was the proportion of patients losing fewer than 15 letters from baseline visual acuity at 12 months.

Results We enrolled 716 patients in the study. At 12 months, 94.5% of the group given 0.3 mg of ranibizumab and 94.6% of those given 0.5 mg lost fewer than 15 letters, as compared with 62.2% of patients receiving sham injections (P<0.001 for both comparisons). Visual acuity improved by 15 or more letters in 24.8% of the 0.3-mg group and 33.8% of the 0.5-mg group, as compared with 5.0% of the sham-injection group (P<0.001 for both doses). Mean increases in visual acuity were 6.5 letters in the 0.3-mg group and 7.2 letters in the 0.5-mg group, as compared with a decrease of 10.4 letters in the sham-injection group (P<0.001 for both comparisons). The benefit in visual acuity was maintained at 24 months. During 24 months, presumed endophthalmitis was identified in five patients (1.0%) and serious uveitis in six patients (1.3%) given ranibizumab.

Conclusions Intravitreal administration of ranibizumab for 2 years prevented vision loss and improved mean visual acuity, with low rates of serious adverse events, in patients with minimally classic or occult (with no classic lesions) choroidal neovascularization secondary to age-related macular degeneration. (ClinicalTrials.gov number, NCT00056836 [ClinicalTrials.gov] .)

Source Information

From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami (P.J.R.); Vitreoretinal Consultants, Methodist Hospital, Houston (D.M.B.); Ophthalmic Consultants of Boston, Boston (J.S.H.); Retina Vitreous Associates Medical Group, Los Angeles (D.S.B.); the Cole Eye Institute, Cleveland Clinic Foundation, Cleveland (P.K.K.); and Genentech, South San Francisco, CA (C.Y.C., R.Y.K.).

Address reprint requests to Dr. Rosenfeld at the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17th St., Miami, FL 33136, or at prosenfeld{at}med.miami.edu.

Full Text of this Article

Related Letters:

Ranibizumab for Neovascular Age-Related Macular Degeneration
Liew G., Mitchell P., Gillies M. C., Wong T. Y., Rosenfeld P. J., Brown D. M., Schneider S., the MARINA and ANCHOR Study Groups
Extract | Full Text | PDF  
N Engl J Med 2007; 356:747-750, Feb 15, 2007. Correspondence

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