A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration nAMD in Australia and the United KingdomReportar como inadecuado




A Retrospective Study of Ranibizumab Treatment Regimens for Neovascular Age-Related Macular Degeneration nAMD in Australia and the United Kingdom - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Advances in Therapy

, Volume 34, Issue 3, pp 703–712

First Online: 31 January 2017Received: 24 November 2016DOI: 10.1007-s12325-017-0483-1

Cite this article as: Johnston, R.L., Carius, HJ., Skelly, A. et al. Adv Ther 2017 34: 703. doi:10.1007-s12325-017-0483-1

Abstract

IntroductionNeovascular 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 TandE in Australia or pro re nata PRN in the UK.

MethodsThis 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 TandE 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.

ResultsBaseline patient characteristics were comparable between the two cohorts. After 1 year of treatment, TandE-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 TandE compared to PRN was concluded based on the change in mean visual acuity gains at 12 months. Over the 12-month follow-up, TandE-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.

ConclusionThe higher injection frequency in the TandE cohort may account for the trend toward improved vision.

FundingNovartis Pharma AG, Basel, Switzerland

KeywordsAnti-vascular endothelial growth factor Neovascular age-related macular degeneration Pro re nata regimen Ranibizumab Real-world data Treat-and-extend regimen Visual acuity Enhanced contentTo view enhanced content for this article go to http:-www.medengine.com-Redeem-D587F06056571C3C.

R. Johnston sadly passed away on 5 September 2016.

Electronic supplementary materialThe 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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Autor: Robert L. Johnston - Hans-Joachim Carius - Adrian Skelly - Alberto Ferreira - Fran Milnes - Paul Mitchell

Fuente: https://link.springer.com/







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