Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis

Szilárd Kiss,1 Pravin U Dugel,2,3 Arshad M Khanani,4 Michael S Broder,5 Eunice Chang,5 Gordon H Sun,5 Adam Turpcu6 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Retinal Consultants of Arizona, Phoenix, AZ, USA; 3USC Roski Eye Institute, Keck School of M...

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Autores principales:	Kiss S, Dugel PU, Khanani AM, Broder MS, Chang E, Sun GH, Turpcu A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Ranibizumab aflibercept bevacizumab regression analysis Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/5915c8a675274007adf5641901b3cf5c
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spelling	oai:doaj.org-article:5915c8a675274007adf5641901b3cf5c2021-12-02T07:03:59ZEndophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis1177-5483https://doaj.org/article/5915c8a675274007adf5641901b3cf5c2018-08-01T00:00:00Zhttps://www.dovepress.com/endophthalmitis-rates-among-patients-receiving-intravitreal-anti-vegf--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Szilárd Kiss,1 Pravin U Dugel,2,3 Arshad M Khanani,4 Michael S Broder,5 Eunice Chang,5 Gordon H Sun,5 Adam Turpcu6 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Retinal Consultants of Arizona, Phoenix, AZ, USA; 3USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 4Sierra Eye Associates, Reno, NV, USA; 5Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA; 6Genentech, Inc., South San Francisco, CA, USA Purpose: Intravitreal (IVT) injections of the anti-vascular endothelial growth factor (VEGF) agents aflibercept, bevacizumab, and ranibizumab are commonly prescribed to treat neovascular age-related macular degeneration (nAMD). Studies comparing inflammation rates in large populations of patients receiving these agents and the treatment of ocular inflammation post-IVT anti-VEGF injections are scarce. In this study, we compared rates of endophthalmitis claims (sterile and infectious) following IVT anti-VEGF injections to determine the risk factors associated with developing endophthalmitis, and examined the claims for subsequent treatment. Patients and methods: This retrospective cohort study of USA claims data examined the risk of developing endophthalmitis following IVT injection of aflibercept, bevacizumab, or ranibizumab in patients with nAMD between 11/18/2011 and 5/31/2013. The primary study outcome was occurrence of endophthalmitis within 30 days of a claim for an IVT anti-VEGF injection. Endophthalmitis rates were calculated separately for aflibercept, bevacizumab, and ranibizumab, followed by pairwise comparisons of endophthalmitis frequencies among the 3 treatments. Results: This analysis included 818,558 injections from 156,594 patients with nAMD. The rates (% [n/N]) of endophthalmitis following aflibercept, bevacizumab, and ranibizumab IVT injections were 0.100% (136/135,973), 0.056% (268/481,572), and 0.047% (94/201,013), respectively. In a multivariate analysis, aflibercept was associated with a significantly higher risk of endophthalmitis vs ranibizumab (adjusted odds ratio, 2.19; 95% CI: 1.68–2.85; P<0.0001). The risk of endophthalmitis was similar for bevacizumab and ranibizumab. Within 14 days after endophthalmitis, 38.6% of cases received injectable antibiotics, 15.3% received injectable steroids, and 30.3% underwent vitrectomy. Conclusion: The rate of endophthalmitis was very low, but higher following IVT injection with aflibercept compared with both bevacizumab and ranibizumab in patients with nAMD. Keywords: ranibizumab, aflibercept, bevacizumab, regression analysisKiss SDugel PUKhanani AMBroder MSChang ESun GHTurpcu ADove Medical PressarticleRanibizumabafliberceptbevacizumabregression analysisOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1625-1635 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ranibizumab aflibercept bevacizumab regression analysis Ophthalmology RE1-994
spellingShingle	Ranibizumab aflibercept bevacizumab regression analysis Ophthalmology RE1-994 Kiss S Dugel PU Khanani AM Broder MS Chang E Sun GH Turpcu A Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis
description	Szilárd Kiss,1 Pravin U Dugel,2,3 Arshad M Khanani,4 Michael S Broder,5 Eunice Chang,5 Gordon H Sun,5 Adam Turpcu6 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Retinal Consultants of Arizona, Phoenix, AZ, USA; 3USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 4Sierra Eye Associates, Reno, NV, USA; 5Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA; 6Genentech, Inc., South San Francisco, CA, USA Purpose: Intravitreal (IVT) injections of the anti-vascular endothelial growth factor (VEGF) agents aflibercept, bevacizumab, and ranibizumab are commonly prescribed to treat neovascular age-related macular degeneration (nAMD). Studies comparing inflammation rates in large populations of patients receiving these agents and the treatment of ocular inflammation post-IVT anti-VEGF injections are scarce. In this study, we compared rates of endophthalmitis claims (sterile and infectious) following IVT anti-VEGF injections to determine the risk factors associated with developing endophthalmitis, and examined the claims for subsequent treatment. Patients and methods: This retrospective cohort study of USA claims data examined the risk of developing endophthalmitis following IVT injection of aflibercept, bevacizumab, or ranibizumab in patients with nAMD between 11/18/2011 and 5/31/2013. The primary study outcome was occurrence of endophthalmitis within 30 days of a claim for an IVT anti-VEGF injection. Endophthalmitis rates were calculated separately for aflibercept, bevacizumab, and ranibizumab, followed by pairwise comparisons of endophthalmitis frequencies among the 3 treatments. Results: This analysis included 818,558 injections from 156,594 patients with nAMD. The rates (% [n/N]) of endophthalmitis following aflibercept, bevacizumab, and ranibizumab IVT injections were 0.100% (136/135,973), 0.056% (268/481,572), and 0.047% (94/201,013), respectively. In a multivariate analysis, aflibercept was associated with a significantly higher risk of endophthalmitis vs ranibizumab (adjusted odds ratio, 2.19; 95% CI: 1.68–2.85; P<0.0001). The risk of endophthalmitis was similar for bevacizumab and ranibizumab. Within 14 days after endophthalmitis, 38.6% of cases received injectable antibiotics, 15.3% received injectable steroids, and 30.3% underwent vitrectomy. Conclusion: The rate of endophthalmitis was very low, but higher following IVT injection with aflibercept compared with both bevacizumab and ranibizumab in patients with nAMD. Keywords: ranibizumab, aflibercept, bevacizumab, regression analysis
format	article
author	Kiss S Dugel PU Khanani AM Broder MS Chang E Sun GH Turpcu A
author_facet	Kiss S Dugel PU Khanani AM Broder MS Chang E Sun GH Turpcu A
author_sort	Kiss S
title	Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis
title_short	Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis
title_full	Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis
title_fullStr	Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis
title_full_unstemmed	Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis
title_sort	endophthalmitis rates among patients receiving intravitreal anti-vegf injections: a usa claims analysis
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/5915c8a675274007adf5641901b3cf5c
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Endophthalmitis rates among patients receiving intravitreal anti-VEGF injections: a USA claims analysis

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