Bevacizumab Versus Ranibizumab in the Treatment of Macular Edema Due to Retinal Vein Occlusion: 6-Month Results of the CRAVE Study

Rajagopal, Rithwick; Shah, Gaurav K.; Blinder, Kevin J.; Altaweel, Michael M.; Eliott, Dean; Wee, R.; Cooper, Blake; Walia, Harpreet S.; Smith, Bradley T.; Joseph, Daniel P.

doi:10.3928/23258160-20150909-09

Cited by 29 publications

(15 citation statements)

References 14 publications

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“…Our results are in line with other real-world studies, which have shown that, in patients with RVO, and as early as at 2 weeks postinjection, CMT reduction is higher with ranibizumab compared to bevacizumab (10). Two prospective trials comparing bevacizumab and ranibizumab in the treatment of RVO (11) or BRVO (12) concluded that both agents had similar effects in reducing macular thickness and improving visual acuity at 6 months (11), even using a PRN regimen, with a mean number of injections of bevacizumab and ranibizumab of 3.2 and 3.0, respectively (12). Therefore, both bevacizumab and ranibizumab are effective, even with real-world treatment regimens using a lower number of injections than recommended.…”

Section: Discussionsupporting

confidence: 91%

Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal

Vaz-Pereira

Marques

Matias

et al. 2017

European Journal of Ophthalmology

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It is estimated that 16.4 million adults are affected by RVO worldwide, corresponding to 13.9 million with BRVO and 2.5 million with CRVO (1). The classification of RVO into BRVO and CRVO is based on the anatomical site of the vascular occlusion. Although the pathogenesis of RVO is not yet fully understood, an increased secretion of the vascular endothelial growth factor (VEGF) is observed, and therefore the use of anti-VEGF agents by intravitreal injections has become common (2). Many treatment regimens have been suggested with anti-VEGF agents, such as monthly injections or injections pro re nata (PRN), but the ideal regimen has not been defined (2) and management in the long-term of RVO-related complications and visual loss has not been established (1).

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Section: Discussionsupporting

confidence: 91%

Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal

Vaz-Pereira

Marques

Matias

et al. 2017

European Journal of Ophthalmology

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“…The majority of patients were treated with the same anti-VEGF agent throughout the study period, but in one-third of the patients, the type of anti-VEGF used was switched at least once, usually from ranibizumab to bevacizumab. The reasons for switching between anti-VEGF therapies were not collected, but as controlled clinical studies 21 , 22 and retrospective case series studies 23 , 24 have suggested that ranibizumab and bevacizumab are similarly effective in the treatment of patients with RVO, and bevacizumab is available at substantially lower cost, 25 patients may have switched from ranibizumab to bevacizumab for cost savings.…”

Section: Discussionmentioning

confidence: 99%

Anti-VEGF treatment of macular edema associated with retinal vein occlusion: patterns of use and effectiveness in clinical practice (ECHO study report 2)

Jumper¹,

Chen²,

Blinder³

et al. 2018

OPTH

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PurposeTo evaluate the efficacy, safety, and injection frequency of vascular endothelial growth factor (VEGF) antagonists in the treatment of macular edema secondary to retinal vein occlusion (RVO) in clinical practice.Patients and methodsA multicenter retrospective study of the medical records of 165 patients (95 branch RVO, 70 central RVO) treated with at least three anti-VEGF injections in the study eye was conducted. Available data collected for at least 6 months after the first injection included Snellen best-corrected visual acuity (BCVA), central retinal thickness (CRT) by time-domain optical coherence tomography (TD-OCT) or spectral-domain optical coherence tomography (SD-OCT), anti-VEGF injections, other treatments/procedures for RVO, and adverse events.ResultsAt baseline prior to anti-VEGF treatment, mean BCVA was 20/80 Snellen equivalent and mean CRT was 499 μm. Mean number of anti-VEGF injections received was 7.1 during the first year, 5.4 during the second year, and 5.9 during the third year; 51.3% (842/1,641) of injections were ranibizumab, 44.1% (724/1,641) were bevacizumab, and 4.6% (75/1,641) were aflibercept. One in five patients received concomitant focal laser treatment. The percentage of patients achieving both BCVA of 20/40 or better and CRT ≤250 μm on TD-OCT or ≤300 μm on SD-OCT at the same visit (primary endpoint) was 26.1% (30/115) after the first anti-VEGF injection and ranged from 20.0% (7/35) to 36.7% (11/30) after the first 16 injections. After each anti-VEGF injection from the 1st to the 16th, <60% of patients achieved 20/40 or better BCVA and ≤70% of patients achieved CRT ≤250 μm on TD-OCT or ≤300 μm on SD-OCT. The most common treatment-related adverse event was blurry or cloudy vision.ConclusionIn this real-world study, a mean of five to seven anti-VEGF injections was administered yearly, and the response to anti-VEGF therapy was suboptimal in many patients. Anti-VEGF therapy was well tolerated.

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“…Rajagopal et al [15] in CRAVE study (Bevacizumab vs Ranibizumab in the treatment of macular edema due to retinal vein occlusion) compared efficacy of monthly ranbizumab or bevacizumab for RVO-ME in a randomised clinical traal. After six months, changes in central macular thickness and visual acuity were not different between the treatment groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ranibizumab and bevacizumab for macular edema associated with retinal vein occlusion

Sharma

Jat

Singh

et al. 2019

Trop J Ophthalmol Otolaryngol

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To assess the effectiveness of intravitreal ranibizumab compared with bevacizumab for the treatment of macular edema associated with retinal vein occlusion (RVO). Methods: This was a retrospective study of 64 eyes with macular edema associated with RVO. Patients received either 1.25 mg of intravitreal bevacizumab (n = 32) or 0.5 mg of intravitreal ranibizumab (n = 32). Visual acuity, clinical bio-microscopic examination and central macular thickness (CMT) by Optical Coherence Tomography (OCT) was assessed at 6 weeks post injection. The CMT before and six weeks after the injection as assessed by OCT were compared. Statistical analysis was performed using paired student t-test. The improvement in CMT was also compared between the two groups, statistical analysis was performed using un-paired student t-test. Results: The best-corrected visual acuity significantly improved from logarithm of the minimal angle of resolution (logMAR) 0.792 ±0.36 at baseline to 0.575 ± 0.34 at 6 weeks in the bevacizumab group (p =0.001) and from logMAR 0.851 ± 0.35 at baseline to 0.336 ± 0.20 at 6 weeks in the ranibizumab group (p = 0.001), which is statistically significant difference. The reduction in CMT was from 545.44 ± 176.43 μm at baseline to 378.34 ±95.13 at 6 weeks in the bevacizumab group (p = 0.001) and 524.25± 195.94 μm at baseline to 243±80.72 μm at 6 weeks in the ranibizumab group (p=0.001) which was also a statistically significant difference (p = 0.001). Conclusions: Both ranibizumab and bevacizumab were effective for the treatment of RVO. The visual outcome and reduction in macular thickness was better by ranibizumab at the earliest follow-up of 6 weeks.

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Bevacizumab Versus Ranibizumab in the Treatment of Macular Edema Due to Retinal Vein Occlusion: 6-Month Results of the CRAVE Study

Abstract: In the treatment of retinal vein occlusion, bevacizumab and ranibizumab have similar effects on reducing macular thickness and improving visual acuity.

Cited by 29 publications

References 14 publications

Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal

Real-World Outcomes of Anti-VEGF Treatment for Retinal Vein Occlusion in Portugal

Anti-VEGF treatment of macular edema associated with retinal vein occlusion: patterns of use and effectiveness in clinical practice (ECHO study report 2)

Comparison of ranibizumab and bevacizumab for macular edema associated with retinal vein occlusion

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