Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada.
Ivey Eye Institute, Western University, London, Ontario, Canada.
Ophthalmologica. 2022;245(3):230-238. doi: 10.1159/000521517. Epub 2021 Dec 30.
The objective of this study is to assess the long-term effectiveness of a treat-and-extend (T&E) anti-vascular endothelial growth factor regimen in patients with neovascular age-related macular degeneration who remain on T&E and those switched from once-monthly (OM) dosing to T&E (OM-T&E).
In this 12-month extension of the 2-year CANTREAT study, patients received intravitreal ranibizumab 0.5 mg in a T&E regimen. Main outcome measures included mean change in best-corrected visual acuity (BCVA) from baseline and from month 24 to month 36; percentages of patients who gained ≥5, ≥10, or ≥15 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters or lost ≥5, ≥10, or ≥15 letters from baseline and from month 24 to month 36; and number of injections administered from baseline and from month 24 to month 36 for both groups.
Of the 139 patients (73 T&E, 66 OM-T&E) in the extension, 121 (68 T&E, 53 OM-T&E) completed 36 months. Mean (standard deviation [SD]) BCVA changes from baseline to the extension last visit (month 33-36) were +6.6 (11.4) letters in the T&E group and +4.8 (14.3) letters in the OM-T&E group, representing maintenance of 24-month gains. The mean (SD) numbers of injections during the extension were 7.3 (2.7) for T&E and 7.1 (2.8) for OM-T&E.
DISCUSSION/CONCLUSION: These findings suggest that after 36 months of treatment, the mean BCVA improvement achieved at 24 months is maintained for both the patients exclusively treated with the T&E regimen and those that switched to T&E after 24 months in the OM regimen.
本研究的目的是评估接受治疗和延长(T&E)抗血管内皮生长因子方案的患者的长期疗效,这些患者继续接受 T&E 治疗,以及从每月一次(OM)剂量转换为 T&E(OM-T&E)的患者。
在这项为期 2 年的 CANTREAT 研究的 12 个月扩展研究中,患者接受玻璃体腔内雷珠单抗 0.5mg 的 T&E 方案治疗。主要观察指标包括从基线到 36 个月时最佳矫正视力(BCVA)的平均变化;从基线到 36 个月时,分别有多少患者增加了≥5、≥10 或≥15 个早期糖尿病视网膜病变治疗研究(ETDRS)字母,或丢失了≥5、≥10 或≥15 个字母;从基线到 36 个月时,两组的注射次数。
在扩展研究的 139 名患者(73 名 T&E,66 名 OM-T&E)中,有 121 名(68 名 T&E,53 名 OM-T&E)完成了 36 个月的治疗。从基线到扩展最后一次就诊(第 33-36 个月)时,T&E 组的 BCVA 平均(标准差[SD])变化为+6.6(11.4)个字母,OM-T&E 组为+4.8(14.3)个字母,这表明维持了 24 个月的增益。扩展期间 T&E 组和 OM-T&E 组的平均(SD)注射次数分别为 7.3(2.7)次和 7.1(2.8)次。
讨论/结论:这些发现表明,在 36 个月的治疗后,在 24 个月时达到的平均 BCVA 改善得到维持,对于仅接受 T&E 方案治疗的患者和在 OM 方案治疗 24 个月后转换为 T&E 的患者都是如此。