title: Ranibizumab for eyes previously treated with pegaptanib or bevacizumab without clinical response.
abstract: OBJECTIVE
  To assess the safety and efficacy of ranibizumab in patients who had inadequate response to pegaptanib or bevacizumab.
  
  
  METHODS
  In this single-center study, 19 patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD) previously treated with pegaptanib (n = 1), bevacizumab (n = 13), or both (n = 5) received 12 monthly ranibizumab injections (0.5 mg). Outcomes were measured from start of previous therapy (baseline) to start of ranibizumab treatment (day 0) through 12 months.
  
  
  RESULTS
  No drug- or injection-related adverse events and no serious adverse events were reported. At 6 and 12 months, 4 and 5 patients gained 3 or more lines of VA, respectively; 3 patients lost less than 3 lines of VA at 6 months, and 6 patients lost less than 3 lines at 12 months. At 6 and 12 months, VA increased by a mean (± standard error of the mean) of 2.06 ± 1.23 and 1.17 ± 0.62 lines, respectively. Central retinal thickness decreased by a mean of 62.65 ± 22.46 and 62.16 ± 29.20 μm at months 6 and 12, respectively. When stratified by pigment epithelial detachment (PED) status, patients without PED had better visual and anatomical outcomes than patients with PED.
  
  
  CONCLUSIONS
  Ranibizumab has favorable safety and efficacy profiles for patients with AMD without previous response to pegaptanib or bevacizumab.
authors: Retina Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. kaiserrick@aol.com
authors: Richard S
authors: RS
authors: Kaiser
authors: Omesh P
authors: OP
authors: Gupta
authors: Carl D
authors: CD
authors: Regillo
authors: Allen C
authors: AC
authors: Ho
authors: Mitchell S
authors: MS
authors: Fineman
authors: James F
authors: JF
authors: Vander
authors: J Arch
authors: JA
authors: McNamara
authors: Gary C
authors: GC
authors: Brown
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D052157:Aptamers, Nucleotide / Q000627:therapeutic use*; D000068258:Bevacizumab; D057915:Drug Substitution; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D019233:Retreatment; D041623:Tomography, Optical Coherence; D017211:Treatment Failure; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D000068258:Bevacizumab; D000069579:Ranibizumab