gms | German Medical Science

22nd Annual Meeting of the German Retina Society

German Retina Society

26.06. - 27.06.2009, Berlin

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Intravitreal Ranibizumab (Lucentis®) is more effective than intravitreal Pegaptanib (Macugen®) in treating exsudative age-related macular degeneration for patients with history of cardiovascular accidents

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  • Egbert Matthé - University Eye Clinic of Dresden
  • D. Sandner - University Eye Clinic of Dresden
  • L. E. Pillunat - University Eye Clinic of Dresden

German Retina Society. 22nd Annual Meeting of the German Retina Society. Berlin, 26.-27.06.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocRG2009-18

doi: 10.3205/09rg19, urn:nbn:de:0183-09rg198

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/rg2009/09rg19.shtml

Published: June 29, 2009

© 2009 Matthé et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: There are two approved and effective ways of treating exsudative age-related macular degeneration: Pegaptanib (Macugen®) and Ranibizumab (Lucentis®). Unspecific inhibition of all VEGF-types by Ranibizumab is discussed to be more dangerous because of suspected higher rates of severe cardiovascular accidents than selective inhibition by Pegaptanib.

Methods: Patients with exsudative age-related macular degeneration were during upload either treated with three times Ranibizumab (group II) when there were no history of cardivascular accident or with a first injection with Ranibizumab and twice Pegaptanib when there were positive history (group I). Best-corrected visual acuity (BCVA) was obtained and compared between the two groups.

Results: In group I 21 eyes, in group II 769 eyes were treated and retrospectively evaluated. Results and BCVA match the expectancies of MARINA-, ANCHOR- and PrONTO-study, but only up to the second injection, at which the groups‘ treatment differs. Group II patients continue to improve, but group I patients lose visual acuity continously until the first visit 4 weeks after the third injection, at which the difference between the groups becomes statistically significant. (group I loses 1.23 lines, group II gain 1.17 lines).

Conclusion: Treatment of patients with a history of cardiovascular accidents with Ranibizumab and Pegaptanib seems to be less effective than treatment with Ranibizumab alone. The presumed lower risk for cardiovascular accidents when treating patients this way seems to results in worse visual acuity during upload and has to be discussed individually with each patient.