A 12-Month Prospective Trial of Inject and Extend Regimen for Ranibizumab Treatment of Age-Related Macular Degeneration

Abstract

This study shows that the Inject and Extend protocol is safe and efficacious for the treatment of age-related macular degeneration. Head-to-head studies are needed to compare directly with other regimens currently in use, as well as economic analysis to investigate the financial implications.

Ranibizumab Treatment in Age-Related Macular Degeneration: A Meta-Analysis of One-Year Results

“…Visual acuity improved significantly better in studies with monthly ranibizumab injections (+ 9.2 ± 0.9 letters) compared to all case series with discontinuous treatment (4.4 ± 3.4 letters). Relatively favourite outcome was observed for series using a treat-and-extend regimen ( [21,40,47], gain of 6.5, 10.8, and 12.0 letters). On average 6.3 ± 2.0 injections (case-weighted: 5.9) were given in the first year.…”

“…So far applied PRN regimens seem to result either in borderline or just sufficient dosing of ranibizumab in the first year of treatment, as exemplified in the well monitored CATT [8], IVAN [50] and HAR-BOR [11] trials. It is obvious that studies using a treat-and-extend (T & E) strategy presented relatively favourite outcome results [21,40,47]. Dosing in T & E-studies was in the upper range of all series with a discontinuous regimen of injections (7.8, 8.0, 8.4 injections).…”

Current state of therapeutic strategies with ranibizumab in neovascular age-related macular degeneration

“…In the presence of recurrence of exudative activity, the next visit is scheduled back to 4 weeks. The Vitreous Retina Macula Consultants of New York Group lead by Dr K. Bailey Freund was the first to analyse this novel approach [29,30], with several later articles confirming the efficacy of it [31][32][33][34].…”

Influence of Vitreomacular Interface on Anti-Vascular Endothelial Growth Factor Therapy Using Treat and Extend Treatment Protocol for Age-Related Macular Degeneration (Vintrex)

“…6 A multitude of other studies validated the impressive results with these anti-VEGF agents, using alternative treatment regimens, including quarterly, as needed or pro re nata, and treat and extend. [7][8][9][10][11] In clinical practice, these drugs are most commonly used in an individualized fashion rather than in a fixed monthly or every other month schedule. Most recently, surveys from the American Society of Retina Specialists indicate that the membership favors a treat and extend regimen (TER) approach for using anti-VEGF agents to treat nAMD.…”

“…Several groups have published results on the TER and have demonstrated significant visual acuity improvements obtained with fewer patient visits and at a lower economic cost. [9][10][11] Based on the American Society of Retinal Specialists Survey 2013, TER is the most commonly adopted treatment for patients with nAMD in the United States.…”