One-Year Outcomes of 1 Dose versus 3 Loading Doses Followed by Pro Re Nata Regimen Using Ranibizumab for Neovascular Age-Related Macular Degeneration: The ARTIS Trial

Fenghua Wang, Yuanzhi Yuan, Ling Wang, Xiaofeng Ye, Jingke Zhao, Mengxi Shen, Qi Zhang, Ding Xu, Guoyou Qin, Wei Zhang, Fei Yuan, Qing Chang, Peiquan Zhao, Fang Wang, Xiaodong Sun, Fenghua Wang, Yuanzhi Yuan, Ling Wang, Xiaofeng Ye, Jingke Zhao, Mengxi Shen, Qi Zhang, Ding Xu, Guoyou Qin, Wei Zhang, Fei Yuan, Qing Chang, Peiquan Zhao, Fang Wang, Xiaodong Sun

Abstract

Purpose. To compare the functional and anatomical outcomes of one dose and three loading doses followed by the pro re nata (PRN) regimen in Chinese neovascular age-related macular degeneration (nvAMD) (including polypoidal choroidal vasculopathy (PCV)) patients. Methods. In this multicenter, prospective, open-label, controlled, 12-month study (ClinicalTrials.gov: NCT02810808), patients were randomized (1 : 1) to 1 dose + PRN (PRN group) or 3 loading doses + PRN (LD group) using intravitreal ranibizumab treatment. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated. The main outcome was the change in BCVA. The noninferiority limit was 5 letters. Results. Forty-five patients in the PRN group and 49 patients in the LD group finished 12-month follow-up. Each group included 4 PCV patients. The mean change in BCVA from baseline was 7.8 letters in the PRN group, compared with 10.9 letters in the LD group (P=0.344). There were no significant differences between two groups in the mean change of CRT (-159.3 μm vs. -120.5 μm) at month 12. The mean number of injections during the 12-month follow-up was 6.0 in the PRN group and 6.8 in the LD group. The proportion of patients who gained an improvement in visual acuity by 15 or more letters was 28.9% in the PRN group and 44.9% in the LD group (P=0.066). Conclusion. One dose + PRN showed noninferior visual gains than 3 loading doses + PRN regimen using ranibizumab in Chinese nvAMD and PCV patients. Number of injections in the PRN group was similar as that in the LD group but remained a potential risk of vision instability during one-year follow-up using OCT-guided retreatment criteria. This trial is registered with NCT02810808.

Conflict of interest statement

The authors have no financial conflicts of interest.

Copyright © 2019 Fenghua Wang et al.

Figures

Figure 1
Figure 1
(a) Time course of best-corrected visual acuity (BCVA); (b) difference in mean change in BCVA at month 3 and month 12 between the study groups. LD group: 3 loading doses followed by the pro re nata regimen (3 + PRN); PRN group: 1 dose followed by the PRN regimen (1 + PRN).
Figure 2
Figure 2
Time course of central retinal thickness (CRT) on optical coherence tomography. LD group: 3 loading doses followed by the pro re nata regimen (3 + PRN); PRN group: 1 dose followed by the PRN regimen (1 + PRN); M: month.

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