Researchers today reported results from the first year of the Comparison of AMD Treatments Trials (CATT), the first head-to-head comparisons of ranibizumab (Lucentis) with bevacizumab (Avastin). The two drugs had equivalent effects on visual acuity at all time points throughout the first year of follow-up. In especially good news for patients, the results show equivalent visual-acuity outcomes with both monthly and as-needed regimens, and no safety issues were observed.
The National Eye Institute, part of the National Institutes of Health, sponsored the randomized trial involving 1,208 patients in 43 centers across the US. Patients were randomly assigned and treated with one of four regimens for a year. They received Lucentis monthly or PRN, or Avastin monthly or PRN. Enrollment criteria required that study participants had active disease.
Patients in the monthly dosing groups received an initial treatment and then had an injection every 28 days. Patients in the PRN groups received an initial treatment and were then examined every 28 days to determine medical need for additional treatment. PRN groups received subsequent treatment when there were signs of disease activity on optical coherence tomography (OCT). Patients in the PRN group received an average of four to five injections over the course of the year.
In a press conference, Daniel F. Martin, MD, study chair for CATT, and chairman of the Cole Eye Institute at the Cleveland Clinic, said that one-year visual acuity results were "virtually identical" between the two drugs.
The mean number of letters gained, the proportion of patients in whom visual acuity was maintained (<15 letters lost), and the proportion of those who had a gain of at least 15 letters were nearly the same for each drug when the regimen was the same.
Patients treated with as-needed bevacizumab compared less favorably with monthly regimens for either bevacizumab or ranibizumab. But the difference was small.