Ranibizumab significantly more effective than standard of care in treating vision loss due to DME

NovartisFirst results of the RESTORE Phase III study show that ranibizumab is significantly more effective than laser treatment, the current standard of care, at treating visual impairment due to diabetic macular edema (DME), a serious complication of diabetes[1].

Results at one year show that 37% of patients treated with ranibizumab 0.5 mg alone, and 43% of those treated with ranibizumab plus laser therapy, gained a substantial vision improvement of 10 letters or more on an eye-chart compared to 16% of patients treated with laser alone[1]. Ranibizumab had a favorable safety profile when used as monotherapy with no new safety risks observed when combined with laser therapy[1].

"These new data add to the body of evidence showing that treatment with ranibizumab produced a rapid improvement in visual acuity with sustained benefit, and may offer patients the prospect of regaining vision they have lost due to this disabling disease," said Professor Gabriele Lang, Head of the Division of Medical Retina and Laser Surgery, Department of Ophthalmology, University of Ulm, Germany. Professor Lang today presented initial results from the RESTORE Phase III study at the meeting of the European Association for the Study of Diabetic Eye Complications (EASDec) in Paris.

Ranibizumab has been approved in more than 80 countries for the treatment of wet age-related macular degeneration (AMD) under the brand name Lucentis®. It is not currently licensed in any market for the treatment of visual impairment due to DME. An application for marketing approval in this indication was submitted to EU health authorities in December 2009.

The RESTORE study showed that over one year, patients treated with ranibizumab plus laser were able to read an additional 5.9 letters on a standard eye-chart, while those treated with ranibizumab alone could read 6.1 letters more than at the start of the study. This compared with patients receiving laser therapy alone who could read an additional 0.8 letters. All figures are mean averages for the year. The study met its primary endpoint (both ranibizumab arms p<0.0001 vs. laser alone)[1].

The safety profile of ranibizumab in RESTORE was consistent with that previously observed in large controlled clinical trials, with no new safety risks observed. No cases of endophthalmitis were reported. Ranibizumab showed a low incidence (less than 1%) of increased intra-ocular pressure (IOP). In terms of systemic safety, there was a low incidence of hypertension (5-8%) and arterial thromboembolic events (3-4%) in all treatment groups[1].

These efficacy and safety data support the results of the pivotal RESOLVE study comparing ranibizumab to sham (or dummy) treatment. This demonstrated that 61% of ranibizumab-treated patients gained 10 letters or more in visual acuity, and formed the basis of the EU submission[3]. The results from RESTORE also follow a US study conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net) showing that after one year, nearly 50% of eyes treated with ranibizumab and laser therapy showed an improvement in vision of 10 letters or more, compared to 28% with laser alone[4].

"Ranibizumab was specifically designed and licensed for use in the eye, and has already been shown in robust, randomized controlled trials to improve vision and vision-related quality of life in patients with wet AMD," said Trevor Mundel, MD, Global Head of Development at Novartis AG. "We are committed to exploring its potential in other ophthalmic diseases where there is an unmet medical need, and these results confirm that it could provide an important new therapeutic option for visually impaired patients with DME."

Diabetes is a disease associated with high levels of blood sugar which can damage many organs over time, including the eyes. Long-term diabetes can result in diabetic retinopathy, an eye disease characterized by changes in the blood vessels of the retina - the light-sensitive layer at the back of the eye. Diabetic retinopathy is a leading cause of blindness in people of working age.

One manifestation of diabetic retinopathy is DME or retinal swelling, which is caused by leakage of fluid in the central portion of the retina called the macula. Because this is the part of the eye responsible for sharp central vision, patients with visual impairment due to DME can find it hard to recognize faces and carry out everyday activities such as reading and driving. DME with visual impairment affects 1-3% of people with diabetes worldwide[2].

Ranibizumab works by neutralizing a protein called vascular endothelial growth factor (VEGF), which is believed to cause abnormal blood vessel growth and leakage beneath the macula.

The randomized, double-masked, multicenter RESTORE study involved 345 DME patients with an average age of 63 years randomized into three treatment arms: ranibizumab 0.5 mg plus sham laser treatment, ranibizumab plus active laser treatment, and sham injection plus active laser treatment. The primary endpoint was the mean change in best corrected visual acuity (BCVA) from baseline to the average level from months one to 12. Key secondary endpoints were the mean change in BCVA over time, and safety[1].

Ranibizumab was developed by Genentech and Novartis. Genentech has the commercial rights to ranibizumab in the US, while Novartis has exclusive rights in the rest of the world.

About Novartis
Novartis provides healthcare solutions that address the evolving needs of patients and societies. Focused solely on healthcare, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, cost-saving generic pharmaceuticals, preventive vaccines, diagnostic tools and consumer health products. Novartis is the only company with leading positions in these areas. In 2009, the Group's continuing operations achieved net sales of USD 44.3 billion, while approximately USD 7.5 billion was invested in R&D activities throughout the Group. Headquartered in Basel, Switzerland, Novartis Group companies employ approximately 100,000 full-time-equivalent associates and operate in more than 140 countries around the world. For more information, please visit http://www.novartis.com.

[1] Lang, G. on behalf of the RESTORE study group. Safety and efficacy of ranibizumab as monotherapy or adjunctive to laser photocoagulation in diabetic macular edema: 12-month results of the RESTORE study. Late-breaker presentation at EASDec Meeting. May 22, 2010.
[2] R Klein, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: IV Diabetic Macular Edema. Ophthalmol 91:1464-1474, 1984. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study Report No 1. Arch Ophthalmol 103, Dec 1985.
[3] Data on file. Novartis Pharma AG.
[4] The Diabetic Retinopathy Clinical Research Network. Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology 2010, in press.

Most Popular Now

Pfizer receives positive FDA Advisory Committee vo…

Pfizer Inc. (NYSE: PFE) announced that the U.S. Food and Drug Administration's (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted that avail...

Engineered bacteria find tumors, then alert the au…

Combining discoveries in cancer immunology with sophisticated genetic engineering, Columbia University researchers have created a sort of "bacterial suicide squad" that ...

First nasal monoclonal antibody treatment for COVI…

A pilot trial by investigators from Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, tested the nasal administration of the ...

US FDA Advisory Committee votes to support effecti…

GSK plc (LSE/NYSE: GSK) announced that the US Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted that the avail...

"Semantic similarity" leads to novel dru…

The words that researchers use to describe their results can be harnessed to discover potential new treatments for Parkinson's disease, according to a new study published...

Tumour cells' response to chemotherapy is driven b…

Cancer cells have an innate randomness in their ability to respond to chemotherapy, which is another tool in their arsenal of resisting treatment, new research led by the...

Pfizer's ZAVZPRET™ (zavegepant) migraine nasal spr…

Pfizer Inc. (NYSE: PFE) today announced the U.S. Food and Drug Administration (FDA) has approved ZAVZPRET™ (zavegepant), the first and only calcitonin gene-related peptid...

Pfizer invests $43 billion to battle cancer

Pfizer Inc. (NYSE: PFE) and Seagen Inc. (Nasdaq: SGEN) today announced that they have entered into a definitive merger agreement under which Pfizer will acquire Seagen, a...

Nanosatellite shows the way to RNA medicine of the…

The RNA molecule is commonly recognized as messenger between DNA and protein, but it can also be folded into intricate molecular machines. An example of a naturally occur...

Gene and cell therapies to combat pancreatic cance…

Pancreatic cancer is an incurable form of cancer, and gene therapies are currently in clinical testing to treat this deadly disease. A comprehensive review of the gene an...

Scientists reveal a potential new approach to trea…

Scientists at the National Institutes of Health and Massachusetts General Hospital in Boston have uncovered a potential new approach against liver cancer that could lead ...

Normalizing tumor blood vessels may improve immuno…

A type of immune therapy called chimeric antigen receptor (CAR)-T cell therapy has revolutionized the treatment of multiple types of blood cancers but has shown limited e...