Anti-VEGF antibody for the treatment of predominantly
classic choroidal neovascularisation in AMD (ANCHOR)
by Dr. Hasan Usmani
· Phase III, randomised, multi-centre double-masked active treatment-controlled trial
· Comparing two different doses of Ranibizumab to verteporfin photodynamic therapy (PDT) in treating subfoveal neovascular macular degeneration.
· 423 patients in the United States, Europe and Australia
· Randomised 1:1:1 to either PDT plus sham injection or to placebo PDT plus Ranibizumab (0.3 mg or 0.5 mg) monthly for 24 months.
· Fluorescein angiography every three months to determine the need for additional PDT or placebo PDT
· patients with predominantly classic CNV
· VA 6/12 – 6/96
· Proportion of subjects losing less than 15 ETDRS letters at one year.
· Change in VA from baseline
· Maintaining vision: patients losing fewer than 15 letters at 12 months
o 94% in Ranibizumab 0.3 mg vs. 96% in Ranibizumab 0.5 mg vs. 64% in PDT group (p < 0.0001)
· Improving vision: patients gaining 15 letters or more
o 36% (Ranibizumab 0.3 mg) vs. 40% (Ranibizumab 0.5 mg) vs. 6% (PDT) (p < 0.0001)
· Other findings:
o Average number of letters gained or lost
· 9 letters gained (Ranibizumab 0.3 mg) vs. 11 letters gained (Ranibizumab 0.5 mg) vs. 10 letters lost PDT (p< 0.0001)
o Severe visual loss
· 0% Ranibizumab vs.13% PDT
o Change in leakage on FFA
· Decreased by average 2 disc areas (DA) in Ranibizumab vs. increased by average 1/3 DA in PDT (p < 0.0001)
· 0% in 0.3mg Ranibizumab vs. 1.4% in 0.5mg Ranibizumab
· 10.2% in 0.3mg Ranibizumab vs.15% in 0.5mg Ranibizumab vs. 2.8% in PDT
· Non-ocular vascular events
· 2.2.% in 0.3mg Ranibizumab vs. 4.3% in 0.5 mg Ranibizumab vs. 2.1% in PDT
· Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S; ANCHOR Study Group. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1432-1444.