Purpose
A previously published study demonstrated a pharmacogenetic association between the minor alleles of two VEGFR2 SNPs and greater improvement in visual acuity (VA) to treatment with ranibizumab, an anti-VEGF drug, in patients with neovascular age-related macular degeneration (nAMD). We evaluated whether this association was replicated among patients who participated in the Comparison of AMD Treatments Trials (CATT) or the Alternative Treatments to Inhibit VEGF in Patients with Age-Related Choroidal Neovascularisation (IVAN) trial.
Design
Cohort studies within randomized clinical trials.
Participants
835 patients participating in CATT and 512 patients participating in IVAN.
Methods
Each patient was genotyped for SNPs rs4576072 and rs6828477 in the VEGFR2 gene.
Main Outcomes Measures
Mean change in VA from baseline one year after initiation of treatment with ranibizumab or bevacizumab. Differences in VA response between the patient group homozygous for the minor allele of each SNP and the other genotype groups were evaluated with analysis of variance. Differences in VA response by the number of minor alleles present for either SNP or both combined were evaluated with tests of linear trend. Analyses were conducted separately for CATT and IVAN participants and with both the studies combined.
Results
No statistically significant difference in mean change in VA was identified between genotypes of either SNP (p≥0.05). Furthermore, a stepwise analysis failed to show a significant interaction for either SNP based upon the number of minor alleles present. The lack of association was similar in both the CATT and IVAN cohorts and whether the analysis combined patients treated with either ranibizumab or bevacizumab or when restricted to patients treated with ranibizumab only.
Conclusions
The CATT and IVAN data do not support a pharmacogenetic association between the two VEGFR2 SNPs, rs4576072 and rs6828477, and change in VA response to anti-VEGF therapy in patients with nAMD.