Comparative analysis of effectiveness research of ranibizumab and aflibercept

A. Plyukhova, O. A. Savochkina
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Abstract

Summary. Intravitreal administration of anti-VEGF drugs is currently the main method of treatment for all types of exudative form of age-related macular degeneration (eAMD). However, most studies did not divide patients. Currently, there are two drugs with a long clinical history of use in Russia for the treatment of neovascular AMD, these are ranibizumab and aflibercept. Data regarding the binding affinity of ranibizumab and aflibercept to VEGF have been inconsistent in in vitro studies. To analyze the effectiveness of aflibercept and ranibizumab in real clinical practice over a three-year follow-up period. Material and methods. The clinical material of the study was the data of examination and treatment of 344 patients (344 eyes) aged 50 to 87 years with a diagnosis of exudative form of age-related macular degeneration on the basis of the Federal State Budget Scientific Institution “NIIGB. Results. During the first treatment, the difference between groups in BCVA (0.51 ± 0.25 for both groups) and CRT (403.3 ± 115.9 for ranibizumab and 364.2 ± 119.6 for aflibercept) during the first year was not noted (p > 0.05). During the third year of observation and treatment in both groups, the same number of IVIs was produced – 3.5. BCVA in the aflibercept group was 0.53 ± 0.30, in the ranibizumab group it was 0.41 ± 0.30 (p < 0.05). In our opinion, the main factor in the stabilization of visual functions in the aflibercept group is more thorough “disease control», while in the ranibizumab group, with a comparable number of injections, visual acuity was lower by the end of the 3rd year of observation, which we attribute to the negative effect of persistent edema, leading to to death of retinal cells. Keywords: age related macular degeneration, anti-VEGF therapy, aflibercept, ranibizumab
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雷尼单抗与阿非利西普疗效研究的对比分析
总结。玻璃体内给药抗vegf药物是目前治疗所有类型渗出型老年性黄斑变性(eAMD)的主要方法。然而,大多数研究并没有对患者进行分类。目前,在俄罗斯有两种具有较长临床使用历史的药物用于治疗新生血管性AMD,它们是雷尼单抗和阿非利塞普。关于雷尼单抗和阿非利西普对VEGF的结合亲和力的数据在体外研究中一直不一致。分析阿非利西普和雷尼单抗在实际临床实践中三年随访期的有效性。材料和方法。该研究的临床资料是根据联邦国家预算科学机构NIIGB的诊断,年龄在50至87岁之间,诊断为渗出性老年性黄斑变性的344例患者(344只眼睛)的检查和治疗数据。结果。在第一次治疗期间,两组第一年的BCVA(两组均为0.51±0.25)和CRT(雷尼单抗为403.3±115.9,阿非利塞普为364.2±119.6)差异无统计学意义(p < 0.05)。在观察治疗的第三年,两组的静脉注射次数相同,均为3.5次。阿非利西普组BCVA为0.53±0.30,雷尼单抗组BCVA为0.41±0.30 (p < 0.05)。我们认为,阿非利西普组视力功能稳定的主要因素是更彻底的“疾病控制”,而雷尼单抗组在注射次数相当的情况下,在观察第3年结束时视力下降,我们认为这是由于持续水肿的负面影响,导致视网膜细胞死亡。关键词:年龄相关性黄斑变性,抗vegf治疗,阿非利塞普,雷尼单抗
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