Estimated cases of blindness and visual impairment from neovascular age-related macular degeneration avoided in Australia by ranibizumab treatment

PLoS One. 2014 Jun 30;9(6):e101072. doi: 10.1371/journal.pone.0101072. eCollection 2014.

Abstract

Intravitreal injections of anti-vascular endothelial growth factor agents, such as ranibizumab, have significantly improved the management of neovascular age-related macular degeneration. This study used patient-level simulation modelling to estimate the number of individuals in Australia who would have been likely to avoid legal blindness or visual impairment due to neovascular age-related macular degeneration over a 2-year period as a result of intravitreal ranibizumab injections. The modelling approach used existing data for the incidence of neovascular age-related macular degeneration in Australia and outcomes from ranibizumab trials. Blindness and visual impairment were defined as visual acuity in the better-seeing eye of worse than 6/60 or 6/12, respectively. In 2010, 14,634 individuals in Australia were estimated to develop neovascular age-related macular degeneration who would be eligible for ranibizumab therapy. Without treatment, 2246 individuals would become legally blind over 2 years. Monthly 0.5 mg intravitreal ranibizumab would reduce incident blindness by 72% (95% simulation interval, 70-74%). Ranibizumab given as needed would reduce incident blindness by 68% (64-71%). Without treatment, 4846 individuals would become visually impaired over 2 years; this proportion would be reduced by 37% (34-39%) with monthly intravitreal ranibizumab, and by 28% (23-33%) with ranibizumab given as needed. These data suggest that intravitreal injections of ranibizumab, given either monthly or as needed, can substantially lower the number of cases of blindness and visual impairment over 2 years after the diagnosis of neovascular age-related macular degeneration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Australia / epidemiology
  • Blindness / drug therapy*
  • Blindness / epidemiology*
  • Blindness / etiology
  • Blindness / prevention & control
  • Female
  • Humans
  • Incidence
  • Macular Degeneration / complications*
  • Macular Degeneration / epidemiology*
  • Male
  • Middle Aged
  • Ranibizumab
  • Sensitivity and Specificity
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Ranibizumab

Grants and funding

This study was funded by Novartis AG and Genentech, Inc. Novartis AG and Genentech, Inc. participated in the design and conduct of the study, in the distribution of the raw data to Outcomes Insights, in the analysis and interpretation of the data and in the preparation of the manuscript. Novartis AG and Genentech, Inc. reviewed the manuscript before submission. Third-party medical writing assistance, but not editorial content sufficient to meet International Committee of Medical Journal Editors (ICMJE) authorship criteria, was funded by Novartis AG.