Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study

Jean-Marie Rakic,1 Anita Leys,2 Heidi Brié,3 Kris Denhaerynck,4 Christy Pacheco,4 Stefaan Vancayzeele,3 Christine Hermans,3 Karen MacDonald,4 Ivo Abraham4,5 1Department of Ophthalmology, Centre Hospitalier Universitaire de Liège, Site du Sart Tilman, Liège, Belgium;...

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Autores principales: Rakic JM, Leys A, Brié H, Denhaerynck K, Pacheco C, Vancayzeele S, Hermans C, MacDonald K, Abraham I
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2013
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Acceso en línea:https://doaj.org/article/68dbf74850fd47c7805c8811c89e837e
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id oai:doaj.org-article:68dbf74850fd47c7805c8811c89e837e
record_format dspace
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Rakic JM
Leys A
Brié H
Denhaerynck K
Pacheco C
Vancayzeele S
Hermans C
MacDonald K
Abraham I
Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study
description Jean-Marie Rakic,1 Anita Leys,2 Heidi Bri&eacute;,3 Kris Denhaerynck,4 Christy Pacheco,4 Stefaan Vancayzeele,3 Christine Hermans,3 Karen MacDonald,4 Ivo Abraham4,5 1Department of Ophthalmology, Centre Hospitalier Universitaire de Li&egrave;ge, Site du Sart Tilman, Li&egrave;ge, Belgium; 2Leuven University Eye Hospital, Leuven, Belgium; 3Novartis Pharma, Vilvoorde, Belgium; 4Matrix45, Tucson, AZ, USA; 5Center for Health Outcomes and Pharmacoeconomic Research, University of Arizona, Tucson, AZ, USA Introduction: The aim of this study was to examine ranibizumab treatment patterns in "real-world" practice and clinical settings, as well as to assess quality of life outcomes over a 24-month period. Materials and methods: This was a prospective, observational, multicenter, open-label study of 0.5 mg of ranibizumab administered intravitreally. Patients were followed over 24 &plusmn; 3 months with intermediate data points at 6 &plusmn; 2 months and 12 &plusmn; 2 months, and a limited data point at 2.5 &plusmn; 1 month that coincided with the end of the loading phase. Outcomes included visual acuity (Early Treatment Diabetic Retinopathy Study), visual function (National Eye Institute Visual Function Questionnaire-25 [NEI VFQ-25]), quality of life (Health Utilities Index Mark III [HUI3]), and safety. Results: A total of 267 patients with wet age-related macular degeneration (mean &plusmn; standard deviation [SD] age = 78.5 &plusmn; 7.3 years; 62.4% were female; 34.5% with dual eye involvement; 74.9% were treatment-na&iuml;ve) were treated (309 eyes were treated). The mean &plusmn; SD Early Treatment Diabetic Retinopathy Study score at baseline was 56.3 &plusmn; 14.3 letters. The mean &plusmn; SD number of injections over 24 months was 7.6 &plusmn; 4.1, including 2.5 &plusmn; 0.7 and 5.9 &plusmn; 3.6 during the loading and maintenance phases, respectively, with corresponding treatment intervals of 4.8 &plusmn; 1.4 weeks and 11.5 &plusmn; 9.5 weeks, respectively. Improvements in visual acuity over baseline were reached at 2.5 months and maintained at 6 months (both P < 0.0001). The mean visual acuity increase over baseline at 12 months was not significant (P = 0.08); the decline over baseline at 24 months statistically significant (P = 0.02). Overall, 94.3% of patients showed stable or improved disease at 6 months and 81.5% of patients showed stable or improved disease at 24 months. At 6 months, improvements over baseline were significant for VFQ-25 (P = 0.03) and HUI3 (P = 0.02), but not at 12 months and 24 months. Improvements in VFQ-25 and HUI3 were maintained at 24 months in 38% and 34% of patients, respectively. In total 78 serious adverse events were reported in 40 patients and 77 nonserious adverse events in 34 patients. Nine serious adverse events and nine nonserious adverse events in 14 patients were suspected to be related to ranibizumab treatment. Conclusion: The "real-world" clinical effectiveness of ranibizumab was evidenced by the initial improvements over baseline in visual acuity and quality of life, as well as the maintenance of these outcomes at baseline levels at 24 months, and this was observed under variable treatment conditions. The findings underscore the need for individualized treatment with regular monitoring to achieve optimal vision and quality of life outcomes. Keywords: ranibizumab, age-related macular degeneration, neovascular macular degeneration, visual acuity, visual function, quality of life
format article
author Rakic JM
Leys A
Bri&amp;eacute; H
Denhaerynck K
Pacheco C
Vancayzeele S
Hermans C
MacDonald K
Abraham I
author_facet Rakic JM
Leys A
Bri&amp;eacute; H
Denhaerynck K
Pacheco C
Vancayzeele S
Hermans C
MacDonald K
Abraham I
author_sort Rakic JM
title Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study
title_short Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study
title_full Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study
title_fullStr Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study
title_full_unstemmed Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study
title_sort real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the helios study
publisher Dove Medical Press
publishDate 2013
url https://doaj.org/article/68dbf74850fd47c7805c8811c89e837e
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spelling oai:doaj.org-article:68dbf74850fd47c7805c8811c89e837e2021-12-02T09:00:49ZReal-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study1177-54671177-5483https://doaj.org/article/68dbf74850fd47c7805c8811c89e837e2013-09-01T00:00:00Zhttp://www.dovepress.com/real-world-variability-in-ranibizumab-treatment-and-associated-clinica-a14404https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Jean-Marie Rakic,1 Anita Leys,2 Heidi Bri&eacute;,3 Kris Denhaerynck,4 Christy Pacheco,4 Stefaan Vancayzeele,3 Christine Hermans,3 Karen MacDonald,4 Ivo Abraham4,5 1Department of Ophthalmology, Centre Hospitalier Universitaire de Li&egrave;ge, Site du Sart Tilman, Li&egrave;ge, Belgium; 2Leuven University Eye Hospital, Leuven, Belgium; 3Novartis Pharma, Vilvoorde, Belgium; 4Matrix45, Tucson, AZ, USA; 5Center for Health Outcomes and Pharmacoeconomic Research, University of Arizona, Tucson, AZ, USA Introduction: The aim of this study was to examine ranibizumab treatment patterns in "real-world" practice and clinical settings, as well as to assess quality of life outcomes over a 24-month period. Materials and methods: This was a prospective, observational, multicenter, open-label study of 0.5 mg of ranibizumab administered intravitreally. Patients were followed over 24 &plusmn; 3 months with intermediate data points at 6 &plusmn; 2 months and 12 &plusmn; 2 months, and a limited data point at 2.5 &plusmn; 1 month that coincided with the end of the loading phase. Outcomes included visual acuity (Early Treatment Diabetic Retinopathy Study), visual function (National Eye Institute Visual Function Questionnaire-25 [NEI VFQ-25]), quality of life (Health Utilities Index Mark III [HUI3]), and safety. Results: A total of 267 patients with wet age-related macular degeneration (mean &plusmn; standard deviation [SD] age = 78.5 &plusmn; 7.3 years; 62.4% were female; 34.5% with dual eye involvement; 74.9% were treatment-na&iuml;ve) were treated (309 eyes were treated). The mean &plusmn; SD Early Treatment Diabetic Retinopathy Study score at baseline was 56.3 &plusmn; 14.3 letters. The mean &plusmn; SD number of injections over 24 months was 7.6 &plusmn; 4.1, including 2.5 &plusmn; 0.7 and 5.9 &plusmn; 3.6 during the loading and maintenance phases, respectively, with corresponding treatment intervals of 4.8 &plusmn; 1.4 weeks and 11.5 &plusmn; 9.5 weeks, respectively. Improvements in visual acuity over baseline were reached at 2.5 months and maintained at 6 months (both P < 0.0001). The mean visual acuity increase over baseline at 12 months was not significant (P = 0.08); the decline over baseline at 24 months statistically significant (P = 0.02). Overall, 94.3% of patients showed stable or improved disease at 6 months and 81.5% of patients showed stable or improved disease at 24 months. At 6 months, improvements over baseline were significant for VFQ-25 (P = 0.03) and HUI3 (P = 0.02), but not at 12 months and 24 months. Improvements in VFQ-25 and HUI3 were maintained at 24 months in 38% and 34% of patients, respectively. In total 78 serious adverse events were reported in 40 patients and 77 nonserious adverse events in 34 patients. Nine serious adverse events and nine nonserious adverse events in 14 patients were suspected to be related to ranibizumab treatment. Conclusion: The "real-world" clinical effectiveness of ranibizumab was evidenced by the initial improvements over baseline in visual acuity and quality of life, as well as the maintenance of these outcomes at baseline levels at 24 months, and this was observed under variable treatment conditions. The findings underscore the need for individualized treatment with regular monitoring to achieve optimal vision and quality of life outcomes. Keywords: ranibizumab, age-related macular degeneration, neovascular macular degeneration, visual acuity, visual function, quality of lifeRakic JMLeys ABri&amp;eacute; HDenhaerynck KPacheco CVancayzeele SHermans CMacDonald KAbraham IDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 1849-1858 (2013)