Ranibizumab prefilled syringes: benefits of reduced syringe preparation times and less complex preparation procedures.

PURPOSE: A recently developed ranibizumab prefilled syringe (PFS) eliminates several preparatory steps versus the standard vial-based method, and is expected to reduce syringe preparation time (SPT) and enhance procedural simplicity for intravitreal injections. METHODS: Syringe preparation times for the ranibizumab PFS and vial were recorded during standard treatment sessions at 2 centers, without randomization. The duration of each step in preparing the syringe was recorded. At each center, total SPT (mean total duration of all syringe preparation steps) for each method was compared using a 2-tailed t test. RESULTS: In total, 97 SPTs were analyzed across both centers. Center 1 SPTs were 46 seconds (PFS) versus 75 seconds (vial; difference, 29 seconds; p<0.001). Center 2 SPTs were 46 seconds (PFS) versus 63 seconds (vial; difference, 17 seconds; p<0.001). This equates to a 27%-39% reduction in SPT when using the PFS rather than the vial, resulting mostly from the reduced number of syringe preparation steps associated with the PFS. CONCLUSIONS: Syringe preparation times for ranibizumab intravitreal injections are significantly shorter with the PFS than with the vial. The time saved by using the PFS may benefit physicians and nurses, and the simplicity of the injection preparation process with the PFS is advantageous.

CHANGES IN VISUAL ACUITY IN PATIENTS WITH WET AGE-RELATED MACULAR DEGENERATION TREATED WITH INTRAVITREAL RANIBIZUMAB IN DAILY CLINICAL PRACTICE: The TWIN Study.

PURPOSE: The real-life LUMIERE study on patients with wet age-related macular degeneration treated with intravitreal ranibizumab in 2006 to 2009 showed that failure to follow recommendations was associated with lower efficacy than had been observed in the development phase. The TWIN Study reviewed the situation in 2010 to 2011. METHODS: Retrospective, descriptive purely observational study of data acquired after 12 months of treatment with intravitreal ranibizumab. RESULTS: In 881 patients (68% women, mean age, 79 years) treated by 21 ophthalmologists, the mean gain in visual acuity was +4.3 ± 15.4 letters (up from 3.2 ± 14.8 in 2006-2009; NS). Significant improvements were documented in the mean interval between diagnosis and treatment initiation (down from 12.6 ± 26.4-7.7 ± 10.9 days; P < 0.001), and in the percentage of patients who received a full course of induction treatment (56.6 vs. 39.6%; P < 0.001). After induction, hardly any patients were monitored every month as recommended, although retreatment was more assiduous (5.6 ± 2.3 vs. 5.1 ± 2.1 injections; P < 0.001). CONCLUSION: Despite improvements in key parameters, the effectiveness of intravitreal ranibizumab is still compromised by poor compliance with the guidelines, especially the frequency of postinduction monitoring that is now the most important determinant of successful treatment.