Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy

Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (A...

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Autores principales:	Chiara Altana, Matthew Gavino Donadu, Stefano Dore, Giacomo Boscia, Gabriella Carmelita, Stefania Zanetti, Francesco Boscia, Antonio Pinna
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	diabetic macular edema intravitreal agents best corrected visual acuity central retinal thickness adverse drug reactions intravitreal drug expenses Medicine R
Acceso en línea:	https://doaj.org/article/8218c4fb2299497e866f8a7d336ebd70
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spelling	oai:doaj.org-article:8218c4fb2299497e866f8a7d336ebd702021-11-25T18:01:54ZClinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy10.3390/jcm102253422077-0383https://doaj.org/article/8218c4fb2299497e866f8a7d336ebd702021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5342https://doaj.org/toc/2077-0383Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (ADRs), and intravitreal drug expenses were assessed. Methods: All DME patients treated with Ranibizumab, Aflibercept, Dexamethasone implant, and Fluocinolone Acetonide implant at the Sassari University Hospital, Italy, between January 2017 and June 2020 were included. Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured. ADRs and drug expenses were analyzed. Results: Two-hundred thirty-one DME patients (mean age: 65 years) received intravitreal agents. Mean CMT and BCVA were 380 μm and 0.5 LogMAR at baseline, 298 μm and 0.44 logMAR after one year (<i>p</i> = 0.04), and 295 μm and 0.4 logMAR at the end of the follow-up period. A total of 1501 intravitreal injections were given; no major ADRs were reported. Treatment cost was €915,000 (€261,429/year). Twenty non-responders to Ranibizumab or Aflibercept were switched to a Dexamethasone implant. In these patients, mean CMT and BCVA were 468 µm and 0.5 LogMar at the time of switching and 362 µm and 0.3 LogMar at the end of the follow-up (<i>p</i> = 0.00014 and <i>p</i> = 0.08, respectively). Conclusion: Results confirm that Ranibizumab, Aflibercept, and Dexamethasone implant are effective and safe in DME treatment. A switch to Dexamethasone implant for patients receiving Aflibercept or Ranibizumab with minimal/no clinical benefit should be considered.Chiara AltanaMatthew Gavino DonaduStefano DoreGiacomo BosciaGabriella CarmelitaStefania ZanettiFrancesco BosciaAntonio PinnaMDPI AGarticlediabetic macular edemaintravitreal agentsbest corrected visual acuitycentral retinal thicknessadverse drug reactionsintravitreal drug expensesMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5342, p 5342 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic macular edema intravitreal agents best corrected visual acuity central retinal thickness adverse drug reactions intravitreal drug expenses Medicine R
spellingShingle	diabetic macular edema intravitreal agents best corrected visual acuity central retinal thickness adverse drug reactions intravitreal drug expenses Medicine R Chiara Altana Matthew Gavino Donadu Stefano Dore Giacomo Boscia Gabriella Carmelita Stefania Zanetti Francesco Boscia Antonio Pinna Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
description	Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (ADRs), and intravitreal drug expenses were assessed. Methods: All DME patients treated with Ranibizumab, Aflibercept, Dexamethasone implant, and Fluocinolone Acetonide implant at the Sassari University Hospital, Italy, between January 2017 and June 2020 were included. Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured. ADRs and drug expenses were analyzed. Results: Two-hundred thirty-one DME patients (mean age: 65 years) received intravitreal agents. Mean CMT and BCVA were 380 μm and 0.5 LogMAR at baseline, 298 μm and 0.44 logMAR after one year (<i>p</i> = 0.04), and 295 μm and 0.4 logMAR at the end of the follow-up period. A total of 1501 intravitreal injections were given; no major ADRs were reported. Treatment cost was €915,000 (€261,429/year). Twenty non-responders to Ranibizumab or Aflibercept were switched to a Dexamethasone implant. In these patients, mean CMT and BCVA were 468 µm and 0.5 LogMar at the time of switching and 362 µm and 0.3 LogMar at the end of the follow-up (<i>p</i> = 0.00014 and <i>p</i> = 0.08, respectively). Conclusion: Results confirm that Ranibizumab, Aflibercept, and Dexamethasone implant are effective and safe in DME treatment. A switch to Dexamethasone implant for patients receiving Aflibercept or Ranibizumab with minimal/no clinical benefit should be considered.
format	article
author	Chiara Altana Matthew Gavino Donadu Stefano Dore Giacomo Boscia Gabriella Carmelita Stefania Zanetti Francesco Boscia Antonio Pinna
author_facet	Chiara Altana Matthew Gavino Donadu Stefano Dore Giacomo Boscia Gabriella Carmelita Stefania Zanetti Francesco Boscia Antonio Pinna
author_sort	Chiara Altana
title	Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
title_short	Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
title_full	Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
title_fullStr	Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
title_full_unstemmed	Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
title_sort	clinical outcome and drug expenses of intravitreal therapy for diabetic macular edema: a retrospective study in sardinia, italy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8218c4fb2299497e866f8a7d336ebd70
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Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy

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