Ranibizumab in Treating Age-Related Macular Degeneration

Aim: To assess the scientific evidence with reference to the following questions:

• What are the effects of ranibizumab treatment on visual acuity in patients with neovascular age-related macular degeneration (AMD)?
• How does treatment affect visual function as experienced by the patient?
• What complications and side effects can be attributed to treatment?
• What does treatment cost? Is it cost effective?

Conclusions and results:

• Monthly treatment with ranibizumab has a substantial inhibitory effect on the course of disease compared to photodynamic therapy or sham injection in patients with neovascular age-related macular degeneration – in follow-up ≤2 years (Evidence Grade 1).
• Monthly treatment improves vision to a substantially higher degree in patients treated with ranibizumab compared to those who received photodynamic therapy or sham injection – in follow-up ≤2 years (Evidence Grade 1).
• Scientific evidence is insufficient regarding the effects of treatment when delivered less frequently than once per month, or for periods exceeding 2 years.
• It is unclear whether treatment can be discontinued, or if further treatments are necessary to maintain the effects (Insufficient Scientific Evidence).
• Scientific evidence is insufficient to assess the cost effectiveness of the method.

Recommendations: No recommendations.

Methods: A systematic literature search was conducted primarily via electronic databases (PubMed and Cochrane Library and EMBASE) until January 2008. For inclusion in the systematic review, articles needed to meet predetermined criteria: the results of the studies should be relevant to the questions posed by the project, ie, have appropriate endpoints, follow-up period, and study design. Ethical and economic implications were considered.

Further research/reviews required: None.

Written by: Anne Christine Berg, SBU, Sweden