Department of Ophthalmology, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
Department of Ophthalmology, Wuhan General Hospital of Guangzhou Military, Wuhan, Hubei, China.
Am J Ophthalmol. 2019 Jan;197:156-167. doi: 10.1016/j.ajo.2018.08.026. Epub 2018 Aug 24.
Age-related macular degeneration (AMD) can cause irreversible vision loss leading to blindness. We aim to evaluate the efficacy and safety of intravitreal injections of 0.5 mg conbercept, a new anti-vascular endothelial growth factor (anti-VEGF) drug, for treatment of AMD on a schedule more manageable for patients.
A prospective, double-masked, multicenter, sham-controlled, phase III randomized trial.
Patients: Patients with choroidal neovascularization (CNV) secondary to AMD were enrolled and randomized to the conbercept group or the sham control group.
The conbercept group received intravitreal injections of conbercept (0.5 mg) once monthly for the first 3 months, then once quarterly until month 12 (3 + Q3M). The sham group received first 3 monthly sham injections and then 3 monthly injections of conbercept (0.5 mg) followed by quarterly administrations until month 12.
The primary endpoint was mean change from baseline in best-corrected visual acuity (BCVA) at month 3.
A total of 114 patients (91.9%) from 9 sites in China completed the 12-month study. At the 3-month primary endpoint, the mean changes in BCVA from baseline were +9.20 letters in the conbercept group and +2.02 letters in the sham group, respectively (P < .001). At 12 months, the mean changes from baseline in BCVA letter score were +9.98 letters in the conbercept group and +8.81 letters in the sham group (P = .64). The most common ocular adverse events were associated with intravitreal injections, such as conjunctival hemorrhage, and increased intraocular pressure.
A conbercept dosing regimen of 3 initial monthly administrations followed by quarterly treatments is effective for treatment of AMD. In previous reports, other anti-VEGF agents were unable to maintain similar clinical benefits with the same regimen.
年龄相关性黄斑变性(AMD)可导致不可逆的视力丧失,进而导致失明。我们旨在评估新型抗血管内皮生长因子(抗 VEGF)药物康柏西普(conbercept)玻璃体腔内注射治疗 AMD 的疗效和安全性,并为患者制定更便于管理的治疗方案。
前瞻性、双盲、多中心、假注射对照、III 期随机临床试验。
患者:招募患有 AMD 相关脉络膜新生血管(CNV)的患者,并将其随机分为康柏西普组或假注射对照组。
康柏西普组患者接受玻璃体腔内注射康柏西普(0.5mg),前 3 个月每月一次,然后每 3 个月一次直至第 12 个月(3+Q3M)。假注射组患者在前 3 个月接受假注射,然后接受 3 个月的康柏西普(0.5mg)注射,随后每 3 个月一次直至第 12 个月。
主要终点是第 3 个月时最佳矫正视力(BCVA)从基线的平均变化。
来自中国 9 个研究中心的 114 例患者(91.9%)完成了 12 个月的研究。在 3 个月的主要终点时,康柏西普组 BCVA 从基线的平均变化为+9.20 个字母,假注射组为+2.02 个字母(P<0.001)。在 12 个月时,康柏西普组 BCVA 字母评分从基线的平均变化为+9.98 个字母,假注射组为+8.81 个字母(P=0.64)。最常见的眼部不良反应与玻璃体腔内注射相关,如结膜下出血和眼内压升高。
康柏西普 3 个初始月剂量治疗后每 3 个月治疗 1 次的治疗方案对 AMD 有效。在之前的报告中,其他抗 VEGF 药物无法用相同的方案维持类似的临床获益。