Comparison Between Ranibizumab Biosimilar, Innovator Ranibizumab and Bevacizumab in a Real-World Situation

Dhanashree Ratra; Krishnakanta Roy; Sneha Giridhar; Sushant Madaan; Sankara Nethralaya Vitreoretinal Study Group

doi:10.1007/s40123-021-00416-4

Comparison Between Ranibizumab Biosimilar, Innovator Ranibizumab and Bevacizumab in a Real-World Situation

Ophthalmol Ther. 2022 Feb;11(1):135-149. doi: 10.1007/s40123-021-00416-4. Epub 2021 Nov 5.

Authors

Dhanashree Ratra¹, Krishnakanta Roy², Sneha Giridhar², Sushant Madaan²; Sankara Nethralaya Vitreoretinal Study Group

Collaborators

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, V Jayaprakash, Eesh Nigam, C Charanya, S Sruthi, Maitreyi Chowdhury, Kalpita Das

Affiliations

¹ Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, 41/18, College Road, Chennai, 600006, India. dhanashreeratra@gmail.com.
² Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, 41/18, College Road, Chennai, 600006, India.

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.

Keywords: Anti VEGF; Biosimilar; Comparison with bevacizumab; DME; Ranibizumab; nAMD.