设为首页         
  
首 页 学术动态   最新资讯   会议专题 学术幻灯 专家访谈 精彩视频 病例讨论 循证指南 积分商城 名家讲堂
当前位置:眼科首页>(ARVO)美国眼科和视觉研究协会年会>正文
[ARVO2012]休斯顿Methodist医院 Eric Chen教授专访

  作者:国际眼科时讯  2012/5/9 14:44:00
国际眼科时讯版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。
内容概要:Dr Chen:我们的研究名为“新生血管性老年黄斑变性的SAVE(超剂量抗VEGF)治疗”,基本上,我们的患者均为接受贝伐单抗或者雷珠单抗传统治疗失败者,每月接受注射治疗,但是仍然存在持续性渗出。我们选择符合入选标准的患者纳入本项规模研究,在研究中,我们给予患者超剂量治疗,治疗剂量是传统剂量的4倍(雷珠单抗的标准治疗剂量是0.5mg,我们给予患者2mg的治疗剂量)。

  <International OphthalmologyTimes>:Can you give us a brief summary of the key messages in your poster?
  Dr Chen: Our poster is called The SAVE (Superdose Anti-VEGF) in neovascular AMD and basically what we have are patients who have failed traditional therapy either on Lucentis or Avastin; receiving these drugs monthly and still having persistent exudation. We enrolled these patients if they fitted the criteria to enter this large study where we gave them what we call a superdose which is four times greater than the standard dosage (0.5mg is the standard dose of ranibizumab (Lucentis) and we gave them a 2mg dose).

  《国际眼科时讯》:您能给我们简单总结一下您研究的关键内容吗?
  Dr Chen:我们的研究名为“新生血管性老年黄斑变性的SAVE(超剂量抗VEGF)治疗”,基本上,我们的患者均为接受贝伐单抗或者雷珠单抗传统治疗失败者,每月接受注射治疗,但是仍然存在持续性渗出。我们选择符合入选标准的患者纳入本项规模研究,在研究中,我们给予患者超剂量治疗,治疗剂量是传统剂量的4倍(雷珠单抗的标准治疗剂量是0.5mg,我们给予患者2mg的治疗剂量)。

  <International OphthalmologyTimes>:What about the patient’s basic characteristics? Are there important differences from other studies?
  Dr Chen: We ended up enrolling 87 patients that we followed over two years. The mean age was around 76 years and they were evenly split between males and females. The important difference between this trial and other trials such as the HARBOR trial where a superdose of ranibizumab was used, is that these were treatment recalcitrant patients; they had already had treatment. Prior to entry into this trial, the average patient had had 24 injections given almost every month. There was an OCT review of all the patients beforehand and around 90% of them had fluid on every single OCT scan. We required a washout period of one month prior to enrollment in this study but the average patient had almost 10.5 injections over the previous one year. They were patients that received constant dosage but still had symptoms including cysts or subretinal fluid or pigment epithelial detachment (PED) on OCTs or FAs or clinical exam.

  《国际眼科时讯》:入组患者的基本特征有哪些?与其它研究相比有什么重要不同吗?
  Dr Chen:在我们的研究中共纳入87例患者,跟踪随访两年。平均年龄在76岁左右,男女各半。本研究与HARBOR等其它雷珠单抗超剂量治疗研究的主要不同之处在于,我们这些患者为顽固性病例,之前已经接受过治疗。在纳入本项研究之前,患者平均接受过24次每月注射治疗。我们对所有患者之前的OCT检查进行了回顾,90%的患者在每次OCT扫描中均存在液体渗出。我们要求患者入组前有一个月的洗脱期,但在之前的一年中患者平均接受过10.5次注射治疗。这些患者接受恒定剂量的治疗,但OCT、荧光素眼底血管造影或者临床检查发现仍存在囊肿、视网膜下积液或者视网膜色素上皮脱离等症状。

  <International OphthalmologyTimes>:Compared with other studies, your results are not totally the same. Could you explain in detail the possible reasons for that?
  Dr Chen: I think the big comparison between our SAVE study and the HARBOR study is that in the HARBOR study, they were treatment na?ve patients; they had never received any treatment previously. They did not show a big difference as far as the high dose ranibizumab versus the standard dose ranibizumab. In our study, the patients had received almost two years of treatment on average. We did see approximately a four letter gain which is statistically significant compared to baseline. We are not really sure why. The Snellen equivalent was approximately 20/41 at the start of the study and on average they each picked up four letters. That is the part that we don’t quite understand. Why did these patients do better? We assume the biggest difference is probably between the treatment na?ve and treatment experienced patients and that there is some difference between the patients in that respect. We are not sure whether that has to do with tachyphylaxis, increased clearance from the vitreous, whether it has something to do with the patient’s genomic makeup; there are a variety of factors but we have not been able to look at all of them as yet.

  《国际眼科时讯》:您的研究结果与其它研究并不完全一致,您能详细解释一下可能的原因吗?
  Dr Chen:我认为,我们SAVE研究与HARBOR最大的对比之处在于HARBOR研究中均是初治患者,之前未接受过任何治疗,患者在雷珠单抗标准剂量治疗组与高剂量治疗组之间并未显示出差异。在我们的研究中,患者平均接受过将近2年时间的治疗,与基线水平相比,患者视力提高接近4个字母,差异有统计学意义。我们尚不清楚确切的原因。研究开始时,Snellen视力接近20/41,患者平均提高4个字母。这是目前我们不甚明白的部分,为什么这些患者会得到改善呢?我们设想,最大的不同可能存在于初治患者与久治患者之间,这两类患者本身存在不同。我们不确定这是否与快速耐受、玻璃体清除率提高有关,或者是与患者的基因相关,影响因素有很多,但目前我们对这些因素还无法做到全面了解。
 



[1]  [2]  下一页


分享 |
 
相关搜索
ARVO VEGF AMD 
 延伸阅读
【本文章已有0 人评论,点击查看。】

用户评论

查看全部评论
推荐视频 more<<  

作者资源

友情链接

国际循环网

国际糖尿病网

国际肝病网

肿瘤瞭望网

中国医师协会眼科医师分会

国际眼科学和视光学学术会议
设为首页 | 加入收藏 | 关于我们 | 联系方式 | 招贤纳士
声明:国际眼科时讯( www.iophthal.com)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。
国际眼科 版权所有 京ICP备18007927号-2   京公网安备 11010502033360号  互联网药品信息服务资格证书编号(京)-非经营性2020-0017
 2011-2021 www.iophthal.com All Rights Reserved