'Comparisons of Age-Related Macular Degeneration Treatments Trial is out of the bag

Although the head-to-head trial of bevacizumab and ranibizumab is being hailed as a landmark study, retina specialists are saying its results are unlikely to change practice patterns in the treatment of age-related macular degeneration.

"The CATT study provides physicians with the confidence that switching from one (treatment) to another is unlikely to harm the patient," said Dr. Huang, the Philip F. and Elizabeth G. Searle-Suber Huang, MD, Professor of Ophthalmology and vice chairman, Department of Ophthalmology & Visual Sciences, Case Western Reserve University School of Medicine, Cleveland. "It gives practitioners the confidence that patients with AMD experience an equally efficacious outcome and a reasonable safety profile."

Based on 1,208 patients randomly assigned in the single-blind noninferiority trial, bevacizumab administered monthly was equivalent to ranibizumab administered monthly, with a mean of 8 and 8.5 letters gained, respectively.

The result did not surprise Philip J. Rosenfeld, MD, PhD, who pioneered the use of bevacizumab just more than 6 years ago when he injected the drug into a patient's eye in early May 2005. Dr. Rosenfeld, professor of ophthalmology at the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, said the trial supports his colleagues' understanding of the drugs' "apparent equivalency."

"My colleagues have already decided which drug to use, based on the assumptions that both drugs have similar efficacy and safety," Dr. Rosenfeld said.

"If patients are doing well, it would be unlikely that retina specialists would change from successful therapy," Dr. Huang agreed.