Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes

Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes

Faye Horner, Peck Lin Lip, Bashar R Mohammed, William Fusi-Rubiano, Eesha Gokhale, Bushra Mushtaq, Randhir Chavan Birmingham & Midland Eye Centre, Birmingham, UKCorrespondence: Randhir ChavanBirmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, City...

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Autores principales: Horner F, Lip PL, Mohammed BR, Fusi-Rubiano W, Gokhale E, Mushtaq B, Chavan R
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
amd
ranibizumab
aflibercept
protocols
prn
treat & extend
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/3daaacb669af4205b2d6cba82c97e077
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spelling oai:doaj.org-article:3daaacb669af4205b2d6cba82c97e0772021-12-02T13:40:23ZComparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes1177-5483https://doaj.org/article/3daaacb669af4205b2d6cba82c97e0772021-04-01T00:00:00Zhttps://www.dovepress.com/comparing-effectiveness-of-three-different-anti-vegf-treatment-regimen-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Faye Horner, Peck Lin Lip, Bashar R Mohammed, William Fusi-Rubiano, Eesha Gokhale, Bushra Mushtaq, Randhir Chavan Birmingham & Midland Eye Centre, Birmingham, UKCorrespondence: Randhir ChavanBirmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, City Hospital Dudley Road, Birmingham, B18 7QH, UKTel +44 121 5543801Fax +44 121 5076791Email rchavan@nhs.netPurpose: To compare and report the 2-year treatment outcomes from 3 different anti-VEGF treatment regimens in treating neovascular aged-related macular degeneration (nAMD): Ranibizumab pro re nata (Ranibizumab-PRN); Ranibizumab treat and extend (Ranibizumab-T&E); Aflibercept fixed first year dosing (7 injections) with treat and extend in subsequent year (Aflibercept-Fixed).Methods: All treatment-naïve nAMD patients who completed 24 months of monitoring from a single treatment center were included. Patients received the initial loading dose of three injections (4-weekly interval), followed by one of the 3 treatment regimens. Primary outcomes were changes in visual acuity (VA) and central retinal thickness (CRT). Secondary outcome was number of injections required in each year. Data analysis included last observation carried forward (LOCF) for patients with incomplete year-2 follow-up.Results: A total of 249 eyes (230 patients) were studied: 121 Ranibizumab-PRN; 65 Ranibizumab-T&E, and 63 Aflibercept-Fixed. Baseline median VA (ETDRS letters) for Ranibizumab-PRN, Ranibizumab-T&E, and Aflibercept-Fixed was 53.9, 61.1, and 54.9 letters, achieving final VA of 54.9, 65.1, and 65.1 letters, respectively. Hence, the number of letters increased at the end of 24 months for each group was +1.0 (Ranibizumab-PRN), +4.0 (Ranibizumab-T&E), highest +10.2 in Aflibercept-Fixed group. Median number of injections over 2 years (year-1/year-2) was 5/1 for Ranibizumab-PRN, 9/6 for Ranibizumab-T&E, and 7/5 for Aflibercept-Fixed. Both Ranibizumab-T&E and Aflibercept-Fixed also shared the same reduction of median CRT (115 μm), higher than Ranibizumab-PRN (83 μm).Conclusion: We report VA improvement from all three different treatment regimens with both Aflibercept-Fixed and Ranibizumab-T&E regimens achieving the same higher final VA. Aflibercept-Fixed dosing may have more favorable efficacy with the highest VA gain and comparatively lower dosing frequency whereas Ranibizumab-T&E may be more efficient than Ranibizumab-PRN regimen, according to our study.Keywords: AMD, Ranibizumab, Aflibercept, protocols, PRN, treat & extendHorner FLip PLMohammed BRFusi-Rubiano WGokhale EMushtaq BChavan RDove Medical Pressarticleamdranibizumabafliberceptprotocolsprntreat & extendOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1703-1713 (2021)
institution DOAJ
collection DOAJ
language EN
topic amd
ranibizumab
aflibercept
protocols
prn
treat & extend
Ophthalmology
RE1-994
spellingShingle amd
ranibizumab
aflibercept
protocols
prn
treat & extend
Ophthalmology
RE1-994
Horner F
Lip PL
Mohammed BR
Fusi-Rubiano W
Gokhale E
Mushtaq B
Chavan R
Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes
description Faye Horner, Peck Lin Lip, Bashar R Mohammed, William Fusi-Rubiano, Eesha Gokhale, Bushra Mushtaq, Randhir Chavan Birmingham & Midland Eye Centre, Birmingham, UKCorrespondence: Randhir ChavanBirmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, City Hospital Dudley Road, Birmingham, B18 7QH, UKTel +44 121 5543801Fax +44 121 5076791Email rchavan@nhs.netPurpose: To compare and report the 2-year treatment outcomes from 3 different anti-VEGF treatment regimens in treating neovascular aged-related macular degeneration (nAMD): Ranibizumab pro re nata (Ranibizumab-PRN); Ranibizumab treat and extend (Ranibizumab-T&E); Aflibercept fixed first year dosing (7 injections) with treat and extend in subsequent year (Aflibercept-Fixed).Methods: All treatment-naïve nAMD patients who completed 24 months of monitoring from a single treatment center were included. Patients received the initial loading dose of three injections (4-weekly interval), followed by one of the 3 treatment regimens. Primary outcomes were changes in visual acuity (VA) and central retinal thickness (CRT). Secondary outcome was number of injections required in each year. Data analysis included last observation carried forward (LOCF) for patients with incomplete year-2 follow-up.Results: A total of 249 eyes (230 patients) were studied: 121 Ranibizumab-PRN; 65 Ranibizumab-T&E, and 63 Aflibercept-Fixed. Baseline median VA (ETDRS letters) for Ranibizumab-PRN, Ranibizumab-T&E, and Aflibercept-Fixed was 53.9, 61.1, and 54.9 letters, achieving final VA of 54.9, 65.1, and 65.1 letters, respectively. Hence, the number of letters increased at the end of 24 months for each group was +1.0 (Ranibizumab-PRN), +4.0 (Ranibizumab-T&E), highest +10.2 in Aflibercept-Fixed group. Median number of injections over 2 years (year-1/year-2) was 5/1 for Ranibizumab-PRN, 9/6 for Ranibizumab-T&E, and 7/5 for Aflibercept-Fixed. Both Ranibizumab-T&E and Aflibercept-Fixed also shared the same reduction of median CRT (115 μm), higher than Ranibizumab-PRN (83 μm).Conclusion: We report VA improvement from all three different treatment regimens with both Aflibercept-Fixed and Ranibizumab-T&E regimens achieving the same higher final VA. Aflibercept-Fixed dosing may have more favorable efficacy with the highest VA gain and comparatively lower dosing frequency whereas Ranibizumab-T&E may be more efficient than Ranibizumab-PRN regimen, according to our study.Keywords: AMD, Ranibizumab, Aflibercept, protocols, PRN, treat & extend
format article
author Horner F
Lip PL
Mohammed BR
Fusi-Rubiano W
Gokhale E
Mushtaq B
Chavan R
author_facet Horner F
Lip PL
Mohammed BR
Fusi-Rubiano W
Gokhale E
Mushtaq B
Chavan R
author_sort Horner F
title Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes
title_short Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes
title_full Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes
title_fullStr Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes
title_full_unstemmed Comparing Effectiveness of Three Different Anti-VEGF Treatment Regimens for Neovascular Age-Related Macular Degeneration: Two Years’ Real-World Clinical Outcomes
title_sort comparing effectiveness of three different anti-vegf treatment regimens for neovascular age-related macular degeneration: two years’ real-world clinical outcomes
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/3daaacb669af4205b2d6cba82c97e077
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