Comparison Between Ranibizumab Biosimilar, Innovator Ranibizumab and Bevacizumab in a Real-World Situation
Dhanashree Ratra, Krishnakanta Roy, Sneha Giridhar, Sushant Madaan, the Sankara Nethralaya Vitreoretinal Study Group, Pramod Bhende, Muna Bhende, Girish Rao, Parveen Sen, Rajiv Raman, Vikas Khetan, Chetan Rao, S. Pradeep, Vinata Muralidharan, G. Suganeswari, Rupak Roy, Debmalya Das, Suchetana Mukherjee, P. S. Rajesh, Vijayvel Jayaprakash, Eesh Nigam, C Charanya, S. Sruthi, Maitreyi Chowdhury, Kalpita Das
Abstract
INTRODUCTION: To analyze the efficacy of biosimilar ranibizumab compared to innovator ranibizumab and bevacizumab. METHODS: We retrospectively analyzed consecutive patients treated with biosimilar ranibizumab for wet age-related macular degeneration (AMD) and macular edema (ME) (due to diabetes and vein occlusion) and compared them with ranibizumab- and bevacizumab-treated patients. RESULTS: Of 202 patients, 67 (33.2%) received biosimilar ranibizumab (BSR), 69 (34.2%) ranibizumab (RBZ) and 66 (32.7%) bevacizumab (BEV). All patients received three consecutive injections followed by pro re nata dosing. The follow-up ranged from 3 to 24 months. The mean numbers of injections were 6.68 for RBZ, 6.4 for BEV and 4.7 for BSR. At 3 months, nAMD (n = 115, 56.9%) and ME (n = 87, 43.1%) groups showed significant improvement in vision and central foveal thickness (CFT) across all three agents. After ≥ 6 months, the effects were maintained in the AMD group but not in the ME group. Maximum effect was seen at 1 month. At no point in time was a significant difference noted among the three anti-vascular endothelial growth factor (anti-VEGF) agents. No major safety concerns were noted. CONCLUSIONS: Biosimilar ranibizumab is comparable to innovator ranibizumab and bevacizumab in efficacy and safety.