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[ARVO2012]加州太平洋医疗中心Anne E. Fung教授专访

玻璃体视网膜  作者:  AnneE.Fung  2012/5/8 15:30:00
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内容概要:Dr Fung:HiPED是一项针对新生血管性黄斑变性并伴有持续性视网膜色素上皮脱离患者的研究。研究中所有入组的患者均曾接受过至少6次贝伐单抗或者雷珠单抗治疗,每两次治疗间隔不超过6周。在连续6次连续注射后,OCT显示仍存在视网膜色素上皮脱离的患者即纳入本研究。

  <International OphthalmologyTimes:>: Could you give us a brief summary of your posters here at ARVO?

  《国际眼科时讯》:您能对本次ARVO会议上报告的HiPED研究要点做一个简要概述吗?
  Dr Fung: The HiPED Study is a study looking at patients who have persistent pigment epithelial detachments (PED) with neovascular macular degeneration. All of the patients in the study had to have been treated with at least six injections of either Avastin or Lucentis no more than six weeks apart. If after the six consecutive injections they still had pigment epithelial detachment on OCT then they could be eligible for our study. All of the patients also had fibrovascular PEDs on the fluorescein angiogram. So we were looking for a particularly difficult subtype to treat and that subtype is this persistent fibrovascular PED. We treated all of the patients with 2mg ranibizumab (Lucentis). All of the patients had at least three baseline injections. Half of the patients were randomized to monthly injections of 2mg ranibizumab; the other half of patients was randomized to the three initial injections followed by as-needed injections.

  Dr Fung:HiPED是一项针对新生血管性黄斑变性并伴有持续性视网膜色素上皮脱离患者的研究。研究中所有入组的患者均曾接受过至少6次贝伐单抗或者雷珠单抗治疗,每两次治疗间隔不超过6周。在连续6次连续注射后,OCT显示仍存在视网膜色素上皮脱离的患者即纳入本研究。同时,荧光素眼底血管造影显示所有患者存在纤维血管性色素上皮脱离。所以,我们的目的是寻找一种难以治疗的亚型,这种亚型就是持续性纤维血管性视网膜色素上皮脱离。我们对所有患者给予2 mg雷珠单抗注射治疗,所有患者在研究初始至少接受3次注射治疗。其后一半的患者随机分配至每月2mg雷珠单抗注射治疗组,另一半的患者为3次初始注射后进行按需治疗。

  <International OphthalmologyTimes:>: Were there any important differences between your subjects compared to other studies?

  《国际眼科时讯》:您所做的研究与其他研究相比主要有哪些不同呢?
  Dr Fung: Our study found that at one year we had 24 of the 40 patients who had completed the study and those patients who had completed the one year had gained on average eight letters which is about 1 ? lines of vision. This is very important because these are patients who had already been treated with the normal dose of Avastin or Lucentis and they have a further improvement with the higher dose of Lucentis. I do think this is different from the HARBOR and SAVE studies because we are looking at a particular subtype whereas those big studies included all of the different subtypes who were all treatment na?ve. I don’t believe that the 2mg dose is necessarily better for all patients because some patients only need the 0.5mg dose. Some patients though, seem to do better with the higher dose and I think that is the subset we are looking at.

  Dr Fung:我们研究发现,在1年随访中40例患者有24例完成了本项研究,并且平均提高8个字母,视力提高11/2行。这很重要,因为这些患者已经接受过正常剂量的贝伐单抗或者雷珠单抗治疗,在接受更高剂量的雷珠单抗治疗后视力进一步提高。我认为,这的确与HARBOR及SAVE研究不同,因为我们只关注一种特殊的亚型,而那些大型研究包括了所有不同亚型的初治患者,可能在开始研究前从未接受过抗VEGF治疗。我认为,2 mg剂量治疗并不是对所有的患者来说都会更好,因为有些患者只需要接受0.5mg的治疗剂量。在某些患者中,更高剂量治疗可能会获得更好的疗效,而这正是我们要关注的类型。
  <International OphthalmologyTimes:>: Compared with the other two studies, the results of your study are not exactly the same. What are the reasons for those differences?

  《国际眼科时讯》:您的研究结果与其他两项研究相比较并不完全一致,导致研究结果不同的原因有哪些?
  Dr Fung: The difference is that the HIPED study is not the same as the HARBOR and SAVE studies because we are looking at a subpopulation of neovascular AMD patients. We are not looking at a general population in the same way as the other two studies were.

  Dr Fung:研究结果不一致的原因在于,HIPED研究与HARBOR和SAVE研究不同,我们研究的是新生血管性年龄相关性黄斑变性中的一种亚人群,而不是像另外两项研究一样着眼于一般人群。



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