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    CATT follow-up explores long-term outcomes with anti-VEGF in AMD

    Mean visual acuity at 5 years points to unmet need; however, 50% of eyes were 20/40 or better

    Philadelphia—The Comparison of Age-related Macular Degeneration Treatments Trials (CATT) follow-up study found that the gains in visual acuity achieved at the end of the 2-year CATT study, a clinical trial of the anti-vascular endothelial growth factor (VEGF) drugs, ranibizumab (Lucentis) and bevacizumab (Avastin, both from Genentech), were not sustained 3 years later. 

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    In the CATT clinical trial, patients were randomly assigned to either ranibizumab or bevacizumab and followed for 2 years after assignment to one of three dosing regimens.

    In this study, 3 years after the end of the CATT clinical trial, the investigators, led by Maureen Maguire, PhD, from the Department of Ophthalmology, University of Pennsylvania, Philadelphia, and Daniel Martin, MD, from the Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, evaluated 647 patients who were recalled from the original CATT clinical trial cohort to determine how the visual acuity levels and anatomic outcomes survived over time in the CATT follow-up study.

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    The CATT Research Group found that in these patients, who had an average follow-up of 5.5 years, half of the eyes had a visual acuity of 20/40 or better, 20% had a visual acuity of 20/200 or worse, and almost 10% had 20/20. The authors reported their findings in Ophthalmology (published online on May 1, 2016).

    They reported that “the mean change in visual acuity was -3 letters from baseline and -11 letters from 2 years.”

    These patients underwent examinations for age-related macular degeneration (AMD) a mean of 25.3 times after the end of the CATT study and received a mean of 15.4 treatments. Regarding the treatments, more than half of the patients (60%) were treated with a drug other than the one to which they had been assigned in the CATT study, according to Dr. Maguire.

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    Among 467 eyes that underwent fluorescein angiography, the images showed that the mean size of the lesions was 12.9 mm2, which was a mean of 4.8 mm2 larger than that at the 2-year visit. The investigators observed geographic atrophy in 41% of the eyes that could be graded and it was subfoveal in 17% of those eyes.

    VA decreases in ranibizumab group 

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