Long-term switching between ranibizumab and aflibercept in neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

Abstract

PURPOSE:

To investigate the rate and timing of switching between ranibizumab and aflibercept and to evaluate the difference in the switching rates among the different subtypes of neovascularization.

METHODS:

This retrospective study included 386 patients (386 eyes) who had been diagnosed with neovascular age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV) and treated with ranibizumab (ranibizumab group, n = 260) or aflibercept (aflibercept group, n = 126). The rate and timing of switching from ranibizumab to aflibercept or vice versa were evaluated. Within the ranibizumab and the aflibercept groups, the switching rates were compared among the 3 subtypes of neovascularization: PCV, type 1 or 2 neovascularization, and type 3 neovascularization.

RESULTS:

During the mean 44.9 ± 15.9 months of follow-up period, switching rate was significantly higher in the ranibizumab group (28.8%, 75 patients) than in the aflibercept group (9.5%, 12 patients) (P < 0.001). No difference was observed in the mean duration between the diagnosis and switching among the ranibizumab (18.7 ± 14.6 months) and the aflibercept groups (14.8 ± 14.5 months) (P = 0.379). In the ranibizumab group, the switching rate was markedly higher in PCV (39.6%) than in type 1 or 2 neovascularization (17.6%) or in type 3 neovascularization (13.3%) (P < 0.001). In the aflibercept group, there was no significant difference in the switching rates among the subtypes of neovascularization (P = 0.811).

CONCLUSIONS:

Although the timings of switching were similar, switching rate was higher in patients undergoing ranibizumab therapy than in those undergoing aflibercept therapy. The switching rate was especially higher in PCV patients undergoing ranibizumab therapy.

• Authors: Jae Hui Kim, Jong Woo Kim, Chul Gu Kim, Dong Won Lee
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 258 Issue 8 Pg. 1677-1685 (Aug 2020) ISSN: 1435-702X [Electronic] Germany
• PMID: 32361804 (Publication Type: Comparative Study, Journal Article, Observational Study)

Chemical References

• Angiogenesis Inhibitors
• Recombinant Fusion Proteins
• aflibercept
• Receptors, Vascular Endothelial Growth Factor
• Ranibizumab

Topics

• Aged
• Angiogenesis Inhibitors (administration & dosage)
• Choroid (blood supply)
• Choroid Diseases (diagnosis, drug therapy)
• Drug Substitution
• Female
• Follow-Up Studies
• Humans
• Intravitreal Injections
• Male
• Polyps (diagnosis, drug therapy)
• Ranibizumab (administration & dosage)
• Receptors, Vascular Endothelial Growth Factor (administration & dosage, antagonists & inhibitors)
• Recombinant Fusion Proteins (administration & dosage)
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Wet Macular Degeneration (diagnosis, drug therapy)