Ranibizumab improves driving prospects for AMD patients

Oct 10 2012

By Sarah Guy, medwireNews Reporter

Treatment with ranibizumab can preserve and even improve the perceived driving ability of patients with age-related macular degeneration (AMD), show the results of two randomized trials.

"Our study, believed to be the first of its kind to look at whether outcomes relevant to driving improve with treatment, suggests that monthly injections of ranibizumab may be an extremely helpful option in allowing the elderly to continue driving," said lead author Neil Bressler (Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland) in a press statement.

A total of 1126 AMD patients from the two trials were randomly assigned to sham (n=238), 0.3 mg ranibizumab (n=378), or 0.5 mg ranibizumab monthly injections (n=380), or to photodynamic therapy(PDT; n=143), and self-reported their driving ability and status perception at baseline then monthly for 24 months using the National Eye Institute Visual Function Questionnaire.

In the Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab in the Treatment of Neovascular Age-Related Macular Degeneration (MARINA) trial, 68.6% of patients reported driving before treatment, while 62.7% from the Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in Age-Related Macular Degeneration (ANCHOR) trial reported doing so.

Corresponding rates of 73.2% and 73.9% of nondrivers from the studies reported not doing so because of their eyesight, report Bressler and colleagues in Ophthalmology.

Among MARINA patients driving at baseline, 67.2% of those who received sham-therapy and 78.4% of those who received 0.5 mg ranibizumab were still driving after 24 months, while respective rates for PDT-treated and ranibizumab-treated patients in ANCHOR were 71.6% and 91.4%.

Indeed, in ANCHOR, the proportion of 0.5 mg ranibizumab-treated patients who reported still driving at 12 months actually increased by 7.8% from baseline, and this figure increased further still at 24 months, to 8.7% higher than baseline.

"One of our next steps is to look at these same outcomes when treatment is given for diabetic macular edema, swelling at the center of the retina as a result of diabetes, the most common cause of vision impairment in working-age adults in the US and abroad," said Bressler.

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