Switch of anti-VEGF agents is an option for nonresponders in the treatment of AMD
Switch of anti-VEGF agents is an option for nonresponders in the treatment of AMD
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DOI：
10.1038/eye.2014.64
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发表时间：
2014-05-01
期刊：
影响因子：
3.9
通讯作者：
Pielen, A.
中科院分区：
文献类型：
--
作者：
Ehlken, C.;Jungmann, S.;Pielen, A.
背景虽然贝伐单抗和雷珠单抗VEGF治疗渗出性AMD在大多数患者中被证明是有效的，但在相当数量的患者中，CNV活性在重复注射后对继续治疗没有反应。这些人被称为无反应者。贝伐单抗或雷珠单抗的药物的变化可能会提供一个替代的选择，用于治疗无反应的渗出性AMD.Methods和材料共138无反应者谁切换治疗从贝伐单抗雷珠单抗（n = 114），反之亦然（n = 24）被列入一项回顾性研究。比较两组转换治疗前后的视力和中心凹厚度。通过线性回归分析，我们分析了可能的预后因素与一个有利的结果为visual acuity.Results线性回归分析显示，无应答者的统计学显着的好处时，治疗改变为不同的抗VEGF药物（贝伐单抗或雷珠单抗）。转换时的VA与改变药物后VA的有益发展呈正相关。与年龄、黄斑厚度、转换前注射次数或转换前治疗下VA的发展无显著相关性。这两个患者切换到安维汀和Lucentis的好处没有统计学显着differentis.Conclusions贝伐单抗与雷珠单抗或反之亦然的交流应考虑在治疗渗出性AMD的无应答者。进一步的预后因素可能有助于识别可能从转换中受益的患者。这些因素应在进一步的研究中进行调查。
Background Although anti-VEGF therapy of exudative AMD with bevacizumab and ranibizumab proved efficacious in the majority of patients, CNV activity does not respond to continued treatment after repeated injections in a considerable amount of patients. These are referred to as nonresponders. A change of the drug to bevacizumab or ranibizumab could possibly offer an alternative option for the treatment of nonresponding exudative AMD.Methods and materials A total of 138 nonresponders who switched therapy from bevacizumab to ranibizumab (n = 114) or vice versa (n = 24) were included in a retrospective study. Visual acuity (VA) and foveal thickness before and after the switch of therapy were compared. By means of linear regression analysis, we analyzed possible prognostic factors associated with a favorable outcome for visual acuity.Results Linear regression analysis revealed a statistically significant benefit for nonresponders when treatment was changed to a different anti-VEGF drug (bevacizumab or ranibizumab). VA at the time of the switch was positively correlated with a beneficial development of VA after changing the drug. There was no significant correlation with age, macular thickness, number of injections before the switch, or the development of VA under treatment before the switch. Both patients switching to Avastin and Lucentis benefitted without statistically significant differences.Conclusions An exchange of bevacizumab with ranibizumab or vice versa should be considered in nonresponders in the treatment of exudative AMD. Further prognostic factors may help to identify patients who might benefit from a switch. These factors should be investigated in further studies.