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A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom

INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is the leading cause of vision loss among persons aged 65 years and older. Anti-vascular endothelial growth factor (anti-VEGF) treatment is the recommended standard of care. The current study compares the effectiveness of ranibizumab...

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Autores principales: Johnston, Robert L., Carius, Hans-Joachim, Skelly, Adrian, Ferreira, Alberto, Milnes, Fran, Mitchell, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350206/
https://www.ncbi.nlm.nih.gov/pubmed/28144918
http://dx.doi.org/10.1007/s12325-017-0483-1
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author Johnston, Robert L.
Carius, Hans-Joachim
Skelly, Adrian
Ferreira, Alberto
Milnes, Fran
Mitchell, Paul
author_facet Johnston, Robert L.
Carius, Hans-Joachim
Skelly, Adrian
Ferreira, Alberto
Milnes, Fran
Mitchell, Paul
author_sort Johnston, Robert L.
collection PubMed
description INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is the leading cause of vision loss among persons aged 65 years and older. Anti-vascular endothelial growth factor (anti-VEGF) treatment is the recommended standard of care. The current study compares the effectiveness of ranibizumab in routine clinical practice in two countries that generally apply two different treatment regimens, treat-and-extend (T&E) in Australia or pro re nata (PRN) in the UK. METHODS: This retrospective, comparative, non-randomised cohort study is based on patients’ data from electronic medical record (EMR) databases in Australia and the UK. Treatment regimens were defined based on location, with Australia as a proxy for analysing T&E and UK as a proxy for analysing PRN. The study included patients with a diagnosis of nAMD who started treatment with ranibizumab between January 2009 and July 2014. A total of 647 eyes of 570 patients in Australia and 3187 eyes of 2755 patients in the UK with complete 12-months follow-up were analysed. RESULTS: Baseline patient characteristics were comparable between the two cohorts. After 1 year of treatment, T&E-treated eyes achieved higher mean (±SE) visual acuity (VA) gains (5.00 ± 0.54 letters [95% confidence interval (CI) 3.93–6.06]) than PRN-treated eyes [3.04 ± 0.24 letters (95% CI 2.57–3.51); difference in means 2.07 ± 0.69 (95% CI 0.73–3.41), p < 0.001]. Non-inferiority of T&E compared to PRN was concluded based on the change in mean visual acuity gains at 12 months. Over the 12-month follow-up, T&E-treated eyes received a higher mean [±standard deviation (SD)] number of injections (9.29 ± 2.43) than PRN-treated eyes (6.04 ± 2.19) (p < 0.0001). Australian patients had a lower mean (±SD) number of total clinic visits (10.29 ± 2.90) than UK patients (11.47 ± 2.93) (p < 0.0001). CONCLUSION: The higher injection frequency in the T&E cohort may account for the trend toward improved vision. FUNDING: Novartis Pharma AG, Basel, Switzerland ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12325-017-0483-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-53502062017-03-27 A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom Johnston, Robert L. Carius, Hans-Joachim Skelly, Adrian Ferreira, Alberto Milnes, Fran Mitchell, Paul Adv Ther Original Research INTRODUCTION: Neovascular age-related macular degeneration (nAMD) is the leading cause of vision loss among persons aged 65 years and older. Anti-vascular endothelial growth factor (anti-VEGF) treatment is the recommended standard of care. The current study compares the effectiveness of ranibizumab in routine clinical practice in two countries that generally apply two different treatment regimens, treat-and-extend (T&E) in Australia or pro re nata (PRN) in the UK. METHODS: This retrospective, comparative, non-randomised cohort study is based on patients’ data from electronic medical record (EMR) databases in Australia and the UK. Treatment regimens were defined based on location, with Australia as a proxy for analysing T&E and UK as a proxy for analysing PRN. The study included patients with a diagnosis of nAMD who started treatment with ranibizumab between January 2009 and July 2014. A total of 647 eyes of 570 patients in Australia and 3187 eyes of 2755 patients in the UK with complete 12-months follow-up were analysed. RESULTS: Baseline patient characteristics were comparable between the two cohorts. After 1 year of treatment, T&E-treated eyes achieved higher mean (±SE) visual acuity (VA) gains (5.00 ± 0.54 letters [95% confidence interval (CI) 3.93–6.06]) than PRN-treated eyes [3.04 ± 0.24 letters (95% CI 2.57–3.51); difference in means 2.07 ± 0.69 (95% CI 0.73–3.41), p < 0.001]. Non-inferiority of T&E compared to PRN was concluded based on the change in mean visual acuity gains at 12 months. Over the 12-month follow-up, T&E-treated eyes received a higher mean [±standard deviation (SD)] number of injections (9.29 ± 2.43) than PRN-treated eyes (6.04 ± 2.19) (p < 0.0001). Australian patients had a lower mean (±SD) number of total clinic visits (10.29 ± 2.90) than UK patients (11.47 ± 2.93) (p < 0.0001). CONCLUSION: The higher injection frequency in the T&E cohort may account for the trend toward improved vision. FUNDING: Novartis Pharma AG, Basel, Switzerland ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12325-017-0483-1) contains supplementary material, which is available to authorized users. Springer Healthcare 2017-01-31 2017 /pmc/articles/PMC5350206/ /pubmed/28144918 http://dx.doi.org/10.1007/s12325-017-0483-1 Text en © The Author(s) 2017 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Johnston, Robert L.
Carius, Hans-Joachim
Skelly, Adrian
Ferreira, Alberto
Milnes, Fran
Mitchell, Paul
A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom
title A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom
title_full A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom
title_fullStr A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom
title_full_unstemmed A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom
title_short A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration (nAMD) in Australia and the United Kingdom
title_sort retrospective study of ranibizumab treatment regimens for neovascular age-related macular degeneration (namd) in australia and the united kingdom
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350206/
https://www.ncbi.nlm.nih.gov/pubmed/28144918
http://dx.doi.org/10.1007/s12325-017-0483-1
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