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Ranibizumab

Trade name Lucentis.

A monoclonal antibody fragment (Fab) created from the same parent mouse antibody as bevacizumab.

It is an anti-angiogenic that has been approved to treat the wet type of age-related macular degeneration.

Targets VEGF-A

US: C

Route of administration is intravitreal injection

Biological half-life approx. 9 days

Its effectiveness is similar to that of bevacizumab, and rates of side effects also appear similar.

However, ranibizumab typically costs $2,000 a dose, while the equivalent dose of bevacizumab typically costs $50.

It is a monoclonal antibody that inhibits angiogenesis by inhibiting Vascular endothelial growth factor A, a mechanism similar to Bevacizumab.

It’s effectiveness for age-related wet macular degeneration is similar to that of bevacizumab and aflibercept.

It has lower risk of stomach and intestinal problems, is also associated with a lower rate of eye related side effects than bevacizumab.

Most common side effects are conjunctival hemorrhage, eye pain, vitreous floaters, increased intraocular pressure, and intraocular inflammation.

The risk for arterial thromboembolic events in patients receiving VEGF-inhibitors by intravitreal injection is low (< 4%) and similar to that seen in patients randomized to placebo.

Serious adverse events related to the procedure: incidence rate of less than 1% and included endophthalmitis, retinal detachment, traumatic cataracts, and intraocular inflammation and blindness.

It is injected into the vitreous humour of the eye once a month, and may be reduced to 1 injection every 3 months after the first 4 months.

Clinical trials (MARINA and ANCHOR) which randomized patients with wet macular degeneration showed that 95% of ranibizumab-treated patients maintained visual acuity compared with 62% of those administered placebo at 1 year, and up to 40% demonstrated an improvement in vision of at least 3 lines.

Randomized controlled trials of patients suffering from macular edema caused by central retinal vein occlusion have similar results.

In a randomized trial vs bevacizumab, the two drugs had equivalent effects on visual acuity when administered according to the same schedule; however, serious adverse events were more common in the bevacizumab arm of the trial, with ocular adverse events about 2.8 times as frequent with bevacizumab than with ranibizumab.

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