Intravitreal Bevacizumab Versus Ranibizumab for Treatment of Neovascular Age-Related Macular Degeneration
Open accessAbstract
Topic To summarize the relative effects of bevacizumab (Avastin; Genentech, Inc, South San Francisco, CA) and ranibizumab (Lucentis; Genentech, Inc.), using findings from a Cochrane Eyes and Vision Group systematic review.Clinical relevance Neovascular age-related macular degeneration (NVAMD) is the most common cause of uncorrectable vision loss among the elderly in developed countries. Bevacizumab and ranibizumab are the most frequently used anti-vascular endothelial growth factor (VEGF) agents injected intravitreally to treat NVAMD.Methods For this systematic review, we included only randomized controlled trials in which the 2 anti-VEGF agents had been compared directly. The primary outcome was 1-year gain in best-corrected visual acuity (BCVA) of ≥15 letters. We followed Cochrane methods for trial selection, data extraction, and data analyses. Relative effects of bevacizumab versus ranibizumab are presented as estimated risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).Results We identified 6 eligible randomized controlled trials with 2809 participants. The proportion of eyes that gained ≥15 letters of BCVA by 1 year was similar for the 2 agents when the same regimens were compared (RR, 0.90; 95% CI, 0.73-1.11). The mean change in BCVA from baseline also was similar (MD, -0.5 letter; 95% CI, -1.6 to +0.6). Other BCVA and quality of life outcomes were similar for the 2 agents. One-year treatment cost with ranibizumab was 5.1 and 25.5 times the cost for bevacizumab in the 2 largest trials. Ocular adverse events were uncommon (<1%), and rates were similar for the 2 agents.Conclusions We found no important difference in effectiveness or safety between bevacizumab and ranibizumab for NVAMD treatment, but there was a large cost difference.
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Two Cochrane meta-analyses comparing ranibizumab and bevacizumab have largely eased safety concerns for neovascular AMD.
“Overall concerns about the relative safety of bevacizumab and ranibizumab when treating patients with neovascular AMD have largely been assuaged by the results of 2 Cochrane comprehensive meta-analyses clinical trials comparing ranibizumab and bevacizumab.15,40”
From Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration (2016) · cites this paper as [15]
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- Authors
- Solomon, S. D., Lindsley, K. B., Krzystolik, M. G., Vedula, S. S., & Hawkins, B. S.
- Affiliations
- Johns Hopkins University (US)
- Massachusetts Eye and Ear Infirmary (US)
- Corresponding author
- Hawkins, Barbara S.
- Venue
- Ophthalmology
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 123
- Issue
- 1
- Pages
- 70-77.e1
- ISSN
- 0161-6420 (ISSN-L)
- PMC
- PMC4695272
- OpenAlex
- W2212725224
- Cited by
- 68
- References
- 22
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 2 · 2021: 8 · 2020: 6 · 2019: 6 · 2018: 11 · 2017: 12 · 2016: 7 · 2014: 1 · 2013: 1
- FWCI
- 9.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Regeneron Pharmaceuticals
- National Eye Institute (EY020522, U01EY020522)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- neovascular age-related macular degeneration, bevacizumab, ranibizumab, intravitreal injection, anti-VEGF therapy, best-corrected visual acuity, visual acuity improvement, treatment costs, ocular adverse effects, quality of life
- MeSH terms
- Bevacizumab, Ranibizumab, Humans, Macular Degeneration, Visual Acuity, Retinal Neovascularization, Randomized Controlled Trials as Topic, Treatment Outcome, Angiogenesis Inhibitors, Intravitreal Injections
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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