Li Xiaoxin, Dai Hong, Li Xiaorong, Han Mei, Li Jun, Suhner Andrea, Lin Renxin, Wolf Sebastian
Department of Ophthalmology, Peking University People's Hospital, No. 11 Xi Zhi Men South Ave., Xicheng District, Beijing, 100044, China.
Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Beijing, China.
Graefes Arch Clin Exp Ophthalmol. 2019 Mar;257(3):529-541. doi: 10.1007/s00417-018-04213-x. Epub 2019 Jan 15.
To demonstrate the efficacy and safety of ranibizumab 0.5 mg pro re nata (PRN) versus laser photocoagulation for the treatment of Chinese patients with visual impairment due to diabetic macular edema (DME).
REFINE was a phase III, 12-month, double-masked, multicenter, laser-controlled study in patients (aged ≥ 18 years) with DME. Patients were randomized 4:1 to receive either ranibizumab 0.5 mg or laser dosing regimen. Efficacy was evaluated as mean average change in best-corrected visual acuity (BCVA) from Months 1 to 12 versus baseline (primary endpoint), anatomical outcomes, treatment exposure, and safety were also assessed.
Ranibizumab was statistically superior (p < 0.001) to laser treatment, with a mean average BCVA gain of 6.8 letters (ranibizumab) over 12 months versus 1.1 letters (laser). At Month 12, mean BCVA gain was 7.8 letters (ranibizumab) and 2.5 letters (laser) from baseline. Patients in the ranibizumab arm received a mean number of 7.9 intravitreal injections, whereas those in the laser arm received a mean of 2.1 treatments. There were no new safety signals.
Ranibizumab 0.5 mg PRN demonstrated a statistically significant and clinically meaningful treatment effect versus laser and was well tolerated in Chinese patients with visual impairment due to DME over 12 months.
比较0.5毫克按需给药的雷珠单抗(PRN)与激光光凝治疗中国糖尿病性黄斑水肿(DME)所致视力损害患者的疗效和安全性。
REFINE是一项为期12个月的III期双盲多中心激光对照研究,纳入年龄≥18岁的DME患者。患者按4:1随机分组,分别接受0.5毫克雷珠单抗或激光给药方案。疗效评估指标为第1至12个月最佳矫正视力(BCVA)相对于基线的平均变化(主要终点),同时评估解剖学结果、治疗暴露情况和安全性。
雷珠单抗在统计学上优于激光治疗(p<0.001),12个月内雷珠单抗组BCVA平均提高6.8个字母,而激光组为1.1个字母。在第12个月时,雷珠单抗组相对于基线的BCVA平均提高7.8个字母,激光组为2.5个字母。雷珠单抗组患者平均接受7.9次玻璃体内注射,而激光组患者平均接受2.1次治疗。未发现新的安全信号。
对于中国DME所致视力损害患者,0.5毫克按需给药的雷珠单抗在12个月内与激光相比显示出具有统计学意义和临床意义的治疗效果,且耐受性良好。