SHORT-TERM EFFICACY OF INTRAVITREAL PATIZRA® (RANIBIZUMAB) IN TREATMENT NAIVE PATIENTS- REAL WORLD EVIDENCE IN PAKISTAN
Keywords:Ranibizumab, Macular Edema, Diabetic Retinopathy, Macular Degeneration, Retinal Vein Occlusion
AbstractBackground: Macular oedema is a final common pathway of a multitude of both ocular and systemic insults. This study was conducted to evaluate the short-term efficacy and safety of intraocular Ranibizumab in patients with macular oedema in a ‘real-world’ setting in Pakistan. Methods: A prospective multicenter study conducted at Amanat Eye Hospitals in Islamabad and Rawalpindi from 1st August 2018 to 1st November 2019. Forty-four eyes of 34 patients with macular oedema were treated with monthly intravitreal Ranibizumab (Patizra®) injections for three consecutive months. Best-corrected visual acuity (BCVA), and optical coherence tomography (OCT) parameters including central retinal thickness (CRT) and macular volume were assessed prior to the injections and then 4 weeks post the final injection and compared. Results: BCVA improved from logMAR 0.61±0.40 at baseline to 0.27±0.35 four weeks after the third intravitreal injection. CRT decreased from 428.54±187.06μm at baseline to 364.50±170.49 μm. Macular volume showed a non-significant decrease from 9.97±3.19 mm3 at baseline to 9.22±2.68 mm3 four weeks after the third intravitreal injection. No systemic or ocular complications were observed during the course of the study. Conclusion: Treatment with intravitreal Patizra® injections was found safe and resulted in clinically and statistically significant improvement in visual acuity and the SD-OCT parameter of central retinal thickness in patients with macular edema secondary to various retinal pathologies. There was no significant decrease in the macular volume.
Johnson MW. Etiology and Treatment of Macular Edema. Am J Ophthalmol 2009;147(1):11–21.
Tranos PG, Wickremasinghe SS, Stangos NT, Topouzis F, Tsinopoulos I, Pavesio CE, et al. Macular edema. Surv Ophthalmol 2004;49(5):470–90.
Rotsos TG, Moschos MM. Cystoid macular edema. Clin Ophthalmol 2008;2(4):919–30.
Yorston D. Anti-VEGF drugs in the prevention of blindness. Community Eye Health 2014;27(87):44–6.
Kaya M, Karahan E, Ozturk T, Kocak N, Kaynak S. Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema with Serous Retinal Detachment. Korean J Ophthalmol 2018;32(4):296–302.
Sacconi R, Giuffre C, Corbelli E, Borrelli E, Querques G, Bandello F. Emerging therapies in the management of macular edema: a review. F1000Res 2019;8:F1000 Faculty Rev-1413.
Wykoff CC, Clark WL, Nielsen JS, Brill JV, Greene LS, Heggen CL, et al. Optimizing Anti-VEGF Treatment Outcomes for Patients with Neovascular Age-Related Macular Degeneration. J Manag Care Spec Pharm 2018;24(2-a Suppl):S3–15.
Eldem B, Lai TYY, Ngah NF, Vote B, Yu HG, Fabre A, et al. An analysis of ranibizumab treatment and visual outcomes in real-world settings: the UNCOVER study. Graefes Arch Clin Exp Ophthalmol 2018;256(5):963–73.
Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 2006;355(14):1432–44.
Holz FG, Bandello F, Gillies M, Mitchell P, Osborne A, Sheidow T, et al. Safety of ranibizumab in routine clinical practice: 1-year retrospective pooled analysis of four European neovascular AMD registries within the LUMINOUS programme. Br J Ophthalmol 2013;97(9):1161–7.
Woo SJ, Cho GE, Cho JH. Short-term Efficacy and Safety of Ranibizumab for Neovascular Age-related Macular Degeneration in the Real World: A Post-marketing Surveillance Study. Korean J Ophthalmol 2019;33(2):150–66.
Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 2006;355(14):1419–31.
Tan NW, Ohno-Matsui K, Koh HJ, Nagai Y, Pedros M, Freitas RL, et al. Long-Term outcomes of ranibizumab treatment of myopic choroidal neovascularization in east-Asian patients from the radiance study. Retina 2018;38(11):2228–38.
Ghanchi F, Hazel CA. South Asian diabetic macular oedema treated with ranibizumab (ADMOR)-real-life experience. Eye (Lond) 2016;30(1):133–8.
Kamei M, Terasaki H, Yoshimura N, Shiraga F, Ogura Y, Grotzfeld AS, et al. Short-term efficacy and safety of ranibizumab for macular oedema secondary to retinal vein occlusion in Japanese patients. Acta Ophthalmol 2017;95(1):e29–35.