To summarize the relative effects of bevacizumab (Avastin®, Genentech, Inc.) and ranibizumab (Lucentis®, Genentech, Inc.), using findings from a Cochrane Eyes and Vision Group systematic review .
Neovascular age-related macular degeneration (NVAMD) is the most common cause of uncorrectable vision loss in the elderly in developed countries. Bevacizumab and ranibizumab are the most frequently-used anti-VEGF agents injected intravitreally to treat NVAMD
We included only randomized controlled trials (RCTs) in which the two anti-VEGF agents had been compared directly. The primary outcome was 1-year gain in best-corrected visual acuity (BCVA) of 15 or more logMAR letters. We followed Cochrane methods for trial selection, data extraction, and data analyses. Relative effects of bevacizumab versus ranibizumab are presented as estimated risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).
We identified 6 eligible RCTs with 2809 participants. The proportion of eyes that gained 15 or more letters of BCVA by 1 year was similar for the two agents when the same regimens were compared: RR=0.90, 95% CI: 0.73 to 1.11. The mean change in BCVA from baseline also was similar: MD=−0.5 letter; 95% CI: −1.6 to +0.6. Other BCVA and quality-of-life outcomes were similar for the two agents. One-year treatment cost with ranibizumab was 5.1 and 25.5 times the cost for bevacizumab in the two largest trials. Ocular adverse events were uncommon (<1%); rates were similar for the two agents.