Bevacizumab in age-related macular degeneration: a randomized controlled trial on the effect of injections every 4 weeks, 6 weeks and 8 weeks

Purpose: Several clinical trials have established the efficacy of ranibizumab therapy administered every 4weeks to treat exudative age-related macular degeneration (ARMD). Bevacizumab appears to be a cost-effective alternative to ranibizumab, although an optimal injection schedule has not yet been determined. In this study, we set out to determine whether bevacizumab treatment in exudative ARMD every 6 or 8weeks is non-inferior to bevacizumab treatment every 4weeks. Methods: A total of 191 patients with exudative ARMD were randomly assigned to a 1-year continuous regimen of intravitreal bevacizumab every 4 (n=64), 6 (n=63) or 8weeks (n=64). The primary outcome was visual acuity change after 1year of treatment. Results: In all three treatment groups, visual acuity improved between baseline and 1year. There was no statistically significant difference in the mean change of visual acuity score at 1year for bevacizumab administered every 4 (1.96 +/- 13.70), 6 (1.60 +/- 10.98) or 8weeks (5.98 +/- 8.88). Reduction in central retinal thickness was observed in all three study groups. At 1year, the mean decrease in central foveal thickness ranged from 86 +/- 97m in the every 6 weeks group to 109 +/- 90m in the group every 8 weeks group (p=0.30). Conclusion: At 1year, bevacizumab administered every 6 or 8weeks was not inferior to therapy administered every 4weeks.