# Switching From Intravitreal Ranibizumab (Lucentis) to Biosimilar Ranibizumab (Ongavia) Injections: Insights From a Tertiary Care Eye Centre

## TL;DR

This study shows that switching from ranibizumab to its biosimilar Ongavia is safe and effective for treating eye conditions like wet AMD, with high patient satisfaction.

## Contribution

The study provides real-world evidence supporting the clinical effectiveness and safety of Ongavia, a biosimilar to ranibizumab, in a tertiary eye care setting.

## Key findings

- 76% of patients were successfully switched to Ongavia with 100% satisfaction with the information process.
- 73.5% of patients maintained or extended treatment intervals with Ongavia, indicating comparable effectiveness.
- No safety concerns were identified with Ongavia, and it could reduce healthcare costs.

## Abstract

Background: Ranibizumab has been widely used to treat retinal conditions such as wet age-related macular degeneration, diabetic macular oedema, and macular oedema secondary to retinal vein occlusions. In 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) approved Ongavia, the first biosimilar of ranibizumab. Ongavia offers comparable efficacy and safety, with a similar side effect profile to the original medication, while being more cost-effective.

Method: The study was conducted in the medical retina department of a tertiary care eye hospital. Data were collected from patients undergoing treatment with intravitreal ranibizumab (Lucentis) who were switched to the ranibizumab biosimilar, Ongavia, between November 2023 and February 2024. This study included two components. The first was a cross-sectional observational survey, in which patients being switched to Ongavia completed a satisfaction questionnaire regarding the information leaflet received and the discussions held about the switch. The second component was a retrospective review to assess the effectiveness and safety of ranibizumab biosimilar Ongavia in patients with wet AMD. After two Ongavia injections, the treatment interval for the next injection was reviewed and compared with the treatment interval with ranibizumab. Similarly, OCT scans before and after the switch were reviewed and compared. Any adverse effects documented in the clinical notes were recorded.

Results: Out of 121 eyes, 92 eyes (76%) were switched to biosimilar ranibizumab (Ongavia) injections, while 18 eyes (15%) continued receiving ranibizumab injections. Patient satisfaction with the information process was 100%. Eighty-seven eyes of patients with wet AMD received more than two Ongavia injections as per the treat-and-extend protocol. Out of these 87 eyes, in 64 eyes (73.5%), injection intervals were either maintained or extended. The treatment interval was reduced in seven eyes (8%), and nine eyes (10.3%) were switched to a different anti-VEGF medication. No safety concerns were identified with biosimilar ranibizumab.

Conclusions: Patient satisfaction with the information process was high, likely due to active involvement in treatment decision-making. The results indicate that the clinical effectiveness of ranibizumab biosimilar Ongavia is comparable to ranibizumab and that it has a similar safety profile. Ongavia could serve as a cost-effective alternative, reducing healthcare system costs while maintaining high standards of patient care.