Ranibizumab: A Review in Retinopathy of Prematurity
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Funding The preparation of this review was not supported by any external funding.
Authorship and Conflict of interest Arnold Lee and Matt Shirley are salaried employees of Adis International Ltd/Springer Nature, are responsible for the article content and declare no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.
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Abstract
Ranibizumab (Lucentis®) is a monoclonal antibody fragment targeted
against VEGF-A that is the first approved anti-VEGF agent for the treatment of
retinopathy of prematurity (ROP). In the pivotal, randomized, phase III RAINBOW
trial in infants with ROP, the majority of intravitreal ranibizumab recipients
experienced treatment success at 24 weeks, with a numerically greater treatment
success rate in the ranibizumab 0.2 mg (80% of patients) than laser therapy
(66%) group without reaching statistical significance for superiority. Long-term
effects on vision following ranibizumab treatment are not yet known, but
interim analyses from the RAINBOW extension study do not show evidence of degraded
vision. Adverse reactions to ranibizumab in pediatric patients were consistent
with the known safety profile in adults, with most adverse reactions attributed
to the intravitreal injection procedure. Furthermore, systemic VEGF suppression
was not observed in clinical trials, which is congruent with the rapid systemic
clearance of ranibizumab. Overall, ranibizumab is an
effective and generally well tolerated treatment for ROP and is not associated
with systemic VEGF suppression. Although results for its long-term effects on
vision are not yet available, ranibizumab is a promising alternative option to
laser therapy for treating ROP.
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