IVAN, CATT studies assess efficacy of two AMD drugs

Fort Lauderdale, FL-The 2-year results of the Comparison of AMD Treatment Trials (CATT) indicate that bevacizumab (Avastin, Genentech) is equivalent to ranibizumab (Lucentis, Genentech) for treating wet age-related macular degeneration (AMD) when similar dosing regimens are compared. In addition, the 1-year results of the randomized controlled trial of alternative treatments to Inhibit VEGF in Age-related choroidal Neovascularisation (IVAN) were presented during a special session at the ARVO annual meeting.

The as-needed regimen was not quite as effective as monthly dosing of the two drugs, said Daniel Martin, MD, who presented the 2-year results of the CATT Study.

The main conclusion about the efficacy of the two anti-vascular endothelial growth factor drugs was based on the results of 1,107 of 1,185 patients who were followed during the second year of the study. Both drugs provided similar mean gains in visual acuity. The mean increase in visual acuity was slightly better with monthly dosing compared with as-needed dosing, regardless of whether the monthly dosing was started initially or at 1 year. The adverse events, such as stroke, heart attack, and death, did not differ between the drugs; however, during the second year there were more serious non-specific adverse events in patients randomly assigned to bevacizumab.

Usha Chakravarty, MD, presented the 1-year results of the randomized controlled trial of alternative treatments to Inhibit VEGF in Age-related choroidal Neovascularisation (IVAN), while also studying the safety and efficacy of the two drugs to determine if the number of treatments can be decreased. Investigators are comparing monthly treatments for 2 years with the two drugs and monthly treatments for 3 months with the two drugs in 600 patients.

Dr. Chakravarty said that for the primary endpoint comparison of visual acuity achieved with the two drugs at 1 year, the results indicated “that the confidence limits straddled both the noninferiority and the 0 line, with a mean difference of 1.99, which we concluded that the comparison was inconclusive. The comparison of the continuous and discontinuous regimens showed no difference between the two drugs.”

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