According to a recent study, stereotactic radiotherapy significantly reduced the treatment burden for patients with nAMD by lowering the need for anti-VEGF injections.
The pivotal, randomized, double-masked, sham-controlled trial published The Lancet, investigated the efficacy of stereotactic radiotherapy (SRT) in treating neovascular age-related macular degeneration (nAMD). The researchers enrolled 411 participants across 30 UK hospitals to evaluate if a single 16-Gray dose of SRT could reduce the frequency of anti-VEGF injections without compromising visual acuity.
Participants aged 50 years and older with chronic active nAMD received either SRT or a sham procedure, alongside intravitreal ranibizumab injections. The primary outcome was the number of injections required over two years, with secondary outcomes including visual acuity and safety.
The SRT group (n=274) required a mean of 10.7 injections (SD, 6.3) over two years, compared to 13.3 injections (SD, 5.8) in the sham group (n=137), representing a 22% reduction (P<0.0001). Visual acuity was stable and non-inferior between groups, with the adjusted mean letter score difference being -1.7 (95% CI, -4.2 to 0.8). The incidence of microvascular abnormalities was higher in the SRT group (35%) compared to the sham group (12%), but these did not adversely affect vision.
Cost analysis demonstrated that the reduction in injections offset the costs of SRT, resulting in a mean savings of £565 per participant (95% CI, -332 to 1483).
“In summary, SRT can reduce the frequency of ranibizumab retreatment for people with chronic, active nAMD, with non-inferior vision versus ranibizumab monotherapy, and acceptable safety,” stated the researchers. “The cost of SRT is more than offset by fewer ranibizumab injections.”
The trial is registered with ClinicalTrials.gov (NCT02243878) and was funded by the Medical Research Council and National Institute for Health and Care Research. Full list of disclosures can be found in the original study.