Comparison of effectiveness and safety between conbercept and ranibizumab for treatment of neovascular age-related macular degeneration. A retrospective case-controlled non-inferiority multiple center study

Abstract

Purpose To compare the efficacy and safety of conbercept and ranibizumab when administered according to a treat-and-extend (TREX) protocol for the treatment of neovascular AMD in China Patients and methods Between May 2014 and May 2015, 180 patients were treated in a 1:1 ratio using conbercept or ranibizumab from 4 hospitals. Patients received either conbercept 0.5mg or ranibizumab 0.5mg intravitreal injections. Follow-up time was one year and treated based on a TREX approach. Main outcomes and measures include BCVA, using Early Treatment Diabetic Retinopathy Study (ETDRS); number of injections; central retinal thickness (CRT); and leakage of CNV before and after the treatment was analyzed by fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA). Results The one-year visit was completed by 168 (93.3%) of patients. Mean BCVA was equivalent between two cohorts, and were improved by 12.7±7.770 and 12.3±7.269 letters in the conbercept and ranibizumab cohorts, respectively (p=0.624). There was no significant difference in measured CRT, with a mean decrease of 191.5 μm for conbercept and 187.8 μm for ranibizumab (p=0.773). There was a statistically significant difference (p=0.001) between the drugs regarding the number of treatments: 7.4 for conbercept and 8.7 for ranibizumab. The difference in the distribution of injection intervals was statistically significant between two groups (p=0.011). During the study, there were no cases of endophthalmitis or intraocular inflammation. Conclusions Both drugs had equivalent effects in visual and anatomic gains at one year when administered. In the conbercept group, longer treatment intervals were achieved with more patients.

Clinical effectiveness of ranibizumab and conbercept for neovascular age-related macular degeneration: a meta-analysis

“…43 Conbercept is a natural conjugator of multiple targets of VEGFR, and so it is reasonable to speculate that it might exhibit a longer duration of action. 18 The concentrations of conbercept in the rabbit retina and choroid remained higher than the in vitro 50% inhibitory concentration value (7 ng/g) 44 over 34 days, indicating that a single 0.5 mg intravitreal injection may have an inhibitory effect against VEGF over the course of 81 days. 41…”

“…Additionally, Huang et al 19 reported no significant difference in the visual improvement of patients with polypoidal choroidal vasculopathy between the conbercept and ranibizumab groups at 6 months; however, conbercept was superior to ranibizumab mono-therapy in the regression of polyps. Moreover, Cui et al 18 confirmed that conbercept and ranibizumab showed equivalent effects with respect to visual gain and reduction of central retinal thickness at 1 year, when administered according to a treat-and-extend protocol.…”

“…However, after 3 months treatment with conbercept or ranibizumab, BCVA significantly differed between the two groups (WMD: −0.04; 95% CI: −0.07 to 0.00; P =0.04). Studies by Cai and Peng 17 and Cui et al 18 were not included because they only showed improvement of vision, rather than BCVA, after treatment with conbercept or ranibizumab. Patients treated with monthly injections of conbercept experienced greater improvement of BCVA from baseline compared with patients treated with ranibizumab.…”

Letter to the Editor

“…We read with interest the article by Cui et al [1]. In the article, the efficacy and safety of conbercept and ranibizumab for neovascular age-related macular degeneration were compared in a retrospective case-controlled non-inferiority study.…”

“…We read with interest the recent article by Avci et al [1] reviewing the 51 cases of optic disc pit maculopathy (OPD-M) treated with pars plana vitrectomy. We would like to share our experience of OPD-M in a child with follow-up for 3 years and emphasize few learning points.…”