The Effects of a Flexible Visual Acuity–Driven Ranibizumab Treatment Regimen in Age-Related Macular Degeneration: Outcomes of a Drug and Disease Model
Open accessAbstract
PURPOSE: Differences in treatment responses to ranibizumab injections observed within trials involving monthly (MARINA and ANCHOR studies) and quarterly (PIER study) treatment suggest that an individualized treatment regimen may be effective in neovascular age-related macular degeneration. In the present study, a drug and disease model was used to evaluate the impact of an individualized, flexible treatment regimen on disease progression. METHODS: For visual acuity (VA), a model was developed on the 12-month data from ANCHOR, MARINA, and PIER. Data from untreated patients were used to model patient-specific disease progression in terms of VA loss. Data from treated patients from the period after the three initial injections were used to model the effect of predicted ranibizumab vitreous concentration on VA loss. The model was checked by comparing simulations of VA outcomes after monthly and quarterly injections during this period with trial data. A flexible VA-guided regimen (after the three initial injections) in which treatment is initiated by loss of >5 letters from best previously observed VA scores was simulated. RESULTS: Simulated monthly and quarterly VA-guided regimens showed good agreement with trial data. Simulation of VA-driven individualized treatment suggests that this regimen, on average, sustains the initial gains in VA seen in clinical trials at month 3. The model predicted that, on average, to maintain initial VA gains, an estimated 5.1 ranibizumab injections are needed during the 9 months after the three initial monthly injections, which amounts to a total of 8.1 injections during the first year. CONCLUSIONS: A flexible, individualized VA-guided regimen after the three initial injections may sustain vision improvement with ranibizumab and could improve cost-effectiveness and convenience and reduce drug administration-associated risks.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
When monthly dosing is not possible, three monthly initiation doses followed by flexible PRN dosing based on monthly monitoring and VA/OCT-guided re-treatment achieve functional and morphological changes close to those after the three initiation doses.
“Where this is not possible, treatment initiation with three initiation (or so called 'loading') doses at monthly intervals followed by flexible dosing (PRN) based on monthly monitoring and VA/OCT guided re-treatment criteria achieve functional and morphological changes close to those achieved after the three initiation doses.26,27”
From Defining response to anti-VEGF therapies in neovascular AMD (2015) · cites this paper as [26]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 42 · Cited by 66
- Authors
- Holz, F. G., Korobelnik, J.-F., Lanzetta, P., Mitchell, P., Schmidt-Erfurth, U., Wolf, S., Markabi, S., Schmidli, H., & Weichselberger, A.
- Affiliations
- University of Bonn (DE)
- Université de Bordeaux (FR)
- University of Udine (IT)
- The University of Sydney (AU)
- Medical University of Vienna (AT)
- the Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland; and
- Novartis (Switzerland) (CH)
- Venue
- Investigative Opthalmology & Visual Science
- Published
- 2010-01-01
- Volume
- 51
- Issue
- 1
- Pages
- 405
- ISSN
- 0146-0404 (ISSN-L)
- 1552-5783
- OpenAlex
- W2073434314
- Cited by
- 66
- References
- 42
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 4 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 5 · 2012: 7
- FWCI
- 11.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Investigative Ophthalmology & Visual Science (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- 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
- ranibizumab, neovascular age-related macular degeneration, individualized treatment regimens, disease progression modeling, visual acuity loss, ANCHOR trial, MARINA trial, vitreous drug concentration, cost-effectiveness
- MeSH terms
- Ranibizumab, Aged, Antibodies, Monoclonal, Female, Humans, Injections, Macular Degeneration, Male, Models, Biological, Visual Acuity, Vitreous Body, Randomized Controlled Trials as Topic, Treatment Outcome, Disease Progression, Retreatment, Angiogenesis Inhibitors, Vascular Endothelial Growth Factor A, Antibodies, Monoclonal, Humanized
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 ›
Are you an author, or do you see a problem with this page? Request a review
