Author: Adrian Hunt (Australia)
Co-authors: Vuong Nguyen, Catherine Creuzot-Garcher, Javier Zarranz-Ventura, Mark Gillies, Daniel Barthelmes, Hemal Mehta
To compare the efficacy of ranibizumab (0.5mg) to aflibercept (2mg) in the treatment of cystoid macular oedema (CMO) due to branch retinal vein occlusion (BRVO) over 12 months in a real-world setting.
A multicentre, international, database observational study recruited 322 eyes initiating therapy in real-world practice over 5 years utilising data from the Fight Retinal Blindness registry.
The main outcome measure was mean change in EDTRS letter scores of visual acuity (VA). Secondary outcomes included anatomic outcomes, percentage of eyes with VA > 6/12 (70 letters), number of injections and visits, time to first inactivity, switching or non-completion.
Generalised mixed effect models demonstrated that mean (95% CI) adjusted 12-month VA changes for ranibizumab and aflibercept were similar (+10.8 [8.2, 13.4] versus +10.9 [8.3, 13.5] letters respectively, p = 0.59). The mean adjusted change in central subfield thickness (CST) was greater for aflibercept than ranibizumab (-170 [-153, -187] μm versus -147 [-130, -164] μm respectively, p = 0.001). The overall median (Q1, Q3) of 7 (4, 8) injections and 9 (7, 11) visits was similar between treatment groups. First grading of inactivity occurred sooner with aflibercept (p = 0.01). Switching was more common from ranibizumab (37 eyes, 23%) than from aflibercept (17 eyes, 11%; p = 0.002).
Visual outcomes at 12 months in this direct comparison of ranibizumab and aflibercept for BRVO in real world practice were generally good and similar for the 2 drugs, despite a greater effect of aflibercept on CST and time to first grading of inactivity.
I have received speaker fees from Allergan and travel sponsorship from Bayer and Novartis - all of which is outside of the submitted work.