Ranibizumab for AMD: Dose and Frequency

Vaidehi S. Dedania, MD; Sophie J. Bakri, MD


December 17, 2013

In This Article


The clinical implications of this study are important for physicians and their patients. Intravitreal ranibizumab dosed at 2.0 mg monthly or PRN was not superior to ranibizumab 0.5 mg dosed similarly, and a PRN dosing regimen was not found to be noninferior to a monthly dosing regimen. Both of these conclusions will have implications for medical costs and the treatment burden experienced by patients.

Although the HARBOR 12-month PRN data are similar to the data from CATT,[4] the PRN dosing regimen was found to be noninferior to monthly dosing in CATT, where there was a 5-letter noninferiority margin, compared with the 4-letter noninferiority margin in the HARBOR study. Whereas treatment burden was reduced in patients on a PRN dosing regimen compared with those on a monthly regimen, visit frequency was similar because monthly monitoring was necessary to maintain visual gains.

Limitations of the HARBOR study include a homogenous study population, unmasking of treatment frequency (monthly vs PRN) to patients and site personnel, and inability to predict outcome beyond a 12-month treatment period.



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