In multiple clinical studies over the past two decades, anti–vascular endothelial growth factor (VEGF) therapy has led to dramatic improvements in the vision of patients with neovascular age-related macular degeneration (nAMD). However, it hasn't always been so easy for ophthalmologists to obtain such positive results in their own practices. Getting real-world patients to adhere to a set schedule of anti-VEGF injections can be a challenge that, if not surmounted, can eventually contribute to indolent visual decline. This has led to the search for alternative, less burdensome means of delivering anti-VEGF therapy.
A Novel System Shows Encouraging Results
Results from the randomized phase 2 Ladder trial evaluated the safety and efficacy of one such option, a surgically implanted port delivery system (PDS) with ranibizumab. The PDS features a permanent implant that can be refilled as needed, without the need to remove it from the eye.
Investigators recruited patients with nAMD who had demonstrated response to at least two prior anti-VEGF intravitreal injections, and had a best corrected visual acuity of 20/20 to 20/200. The 220 eligible patients were then randomly assigned to one of three PDS treatment arms with ranibizumab—10 mg/mL, 40 mg/mL, or 100 mg/mL—or monthly intravitreal injections of ranibizumab 0.5 mg.
