Document Detail


Ranibizumab for neovascular age-related macular degeneration.
MedLine Citation:
PMID:  17021318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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].).
Authors:
Philip J Rosenfeld; David M Brown; Jeffrey S Heier; David S Boyer; Peter K Kaiser; Carol Y Chung; Robert Y Kim;
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Publication Detail:
Type:  Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  355     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-05     Completed Date:  2006-10-18     Revised Date:  2007-02-22    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1419-31     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2006 Massachusetts Medical Society.
Affiliation:
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA. prosenfeld@med.miami.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00056836
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiogenesis Inhibitors / administration & dosage,  adverse effects,  therapeutic use*
Antibodies, Monoclonal / administration & dosage,  adverse effects,  therapeutic use*
Choroidal Neovascularization / drug therapy
Double-Blind Method
Female
Humans
Injections
Macular Degeneration / drug therapy*,  pathology
Male
Middle Aged
Optic Disk / pathology
Visual Acuity / drug effects
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/ranibizumab
Comments/Corrections
Comment In:
N Engl J Med. 2006 Oct 5;355(14):1409-12   [PMID:  17021315 ]
N Engl J Med. 2007 Feb 15;356(7):748-9; author reply 749-50   [PMID:  17310523 ]
N Engl J Med. 2007 Feb 15;356(7):747-8; author reply 749-50   [PMID:  17301310 ]
N Engl J Med. 2006 Oct 5;355(14):1493-5   [PMID:  17021326 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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