Cited by 2,669Retinal Diseases and TreatmentsRetinal and Macular SurgeryOcular Diseases and Behçet’s Syndrome

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Ranibizumab and Bevacizumab for Neovascular Age-Related Macular Degeneration

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The CATT Research Group·2011·New England Journal of Medicine

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Abstract

BACKGROUND: Clinical trials have established the efficacy of ranibizumab for the treatment of neovascular age-related macular degeneration (AMD). In addition, bevacizumab is used off-label to treat AMD, despite the absence of similar supporting data. METHODS: In a multicenter, single-blind, noninferiority trial, we randomly assigned 1208 patients with neovascular AMD to receive intravitreal injections of ranibizumab or bevacizumab on either a monthly schedule or as needed with monthly evaluation. The primary outcome was the mean change in visual acuity at 1 year, with a noninferiority limit of 5 letters on the eye chart. RESULTS: Bevacizumab administered monthly was equivalent to ranibizumab administered monthly, with 8.0 and 8.5 letters gained, respectively. Bevacizumab administered as needed was equivalent to ranibizumab as needed, with 5.9 and 6.8 letters gained, respectively. Ranibizumab as needed was equivalent to monthly ranibizumab, although the comparison between bevacizumab as needed and monthly bevacizumab was inconclusive. The mean decrease in central retinal thickness was greater in the ranibizumab-monthly group (196 μm) than in the other groups (152 to 168 μm, P=0.03 by analysis of variance). Rates of death, myocardial infarction, and stroke were similar for patients receiving either bevacizumab or ranibizumab (P>0.20). The proportion of patients with serious systemic adverse events (primarily hospitalizations) was higher with bevacizumab than with ranibizumab (24.1% vs. 19.0%; risk ratio, 1.29; 95% confidence interval, 1.01 to 1.66), with excess events broadly distributed in disease categories not identified in previous studies as areas of concern. CONCLUSIONS: At 1 year, bevacizumab and ranibizumab had equivalent effects on visual acuity when administered according to the same schedule. Ranibizumab given as needed with monthly evaluation had effects on vision that were equivalent to those of ranibizumab administered monthly. Differences in rates of serious adverse events require further study. (Funded by the National Eye Institute; ClinicalTrials.gov number, NCT00593450.).

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Authors: The CATT Research Group
Corresponding author: The CATT Research Group
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2011-05-19
Volume: 364
Issue: 20
Pages: 1897-1908
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa1102673
PMC: PMC3157322
OpenAlex: W1481978003
Cited by: 2,669
References: 21
Citations by year: 2026: 78 · 2025: 91 · 2024: 116 · 2023: 111 · 2022: 127 · 2021: 164 · 2020: 195 · 2019: 151 · 2018: 168 · 2017: 177 · 2016: 199 · 2015: 238 · 2014: 264 · 2013: 248 · 2012: 265
FWCI: 254.47
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Eye Institute (U10EY017825, U10EY017826, U10EY017823, U10EY017828)
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Ophthalmology › Retinal and Macular Surgery
Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
Keywords: neovascular age-related macular degeneration, ranibizumab, bevacizumab, intravitreal injection, anti-VEGF therapy, visual acuity, central retinal thickness, treatment schedule, non-inferiority, serious adverse events, off-label drug use, anti-angiogenic therapy, comparative efficacy and safety, hospitalization
MeSH terms: Bevacizumab, Ranibizumab, Aged, Aged, 80 and over, Antibodies, Monoclonal, Cardiovascular Diseases, Drug Administration Schedule, Female, Humans, Macular Degeneration, Male, Middle Aged, Retina, Therapeutic Equivalency, Visual Acuity, Proportional Hazards Models, Single-Blind Method, Off-Label Use, Intention to Treat Analysis, Antibodies, Monoclonal, Humanized

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Ranibizumab and Bevacizumab for Neovascular Age-Related Macular Degeneration

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