Fixed monthly versus less frequent ranibizumab dosing and predictors of visual response in exudative age-related macular degeneration

Purpose. to examine temporal patterns of visual acuity (va) response to pooled 0.3 mg/0.5 mg ranibizumab treatment in patients with age-related macular degeneration and identify potential baseline predictors of response. design. retrospective analysis. methods. results from 1824 ranibizumab-treated patients receiving fixed monthly,quarterly,or as-needed dosing after three monthly loading doses in four phase iii/iiib trials (anchor,marina,pier,and sailor) were analyzed. results. at month 3,14.9% to 29.4% of patients had gained ≥15 letters. not all patients achieved peak gains at month 3; many continued to have va increases throughout treatment. after three monthly loading doses,continued monthly dosing resulted in further gains,as there were more delayed 15-letter responders at month 12 (14.7-16.1%) than with less frequent dosing (5.0-6.0%). monthly dosing also resulted in more patients maintaining va gains at later time points. early 15-letter responders had lower baseline mean va than delayed 15-letter responders in anchor and marina; no other differences in baseline characteristics were noted. conclusions. although some patients have rapid improvements in va,others do not experience peak va until later during treatment. continued monthly dosing resulted in a greater percentage of patients gaining ≥15 letters than with switching to less frequent dosing regimens. © 2012 seenu m. hariprasad et al.