Characterising treatment outcomes of patients achieving quarterly aflibercept dosing for neovascular age-related macular degeneration: real-world clinical outcomes from a large tertiary care centre

Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study o...

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Veröffentlicht in:Eye (London) 2023-03, Vol.37 (4), p.779-784
Hauptverfasser: Fu, Dun Jack, Hanumunthadu, Daren, Keenan, Tiarnan D. L., Wagner, Siegfried, Balsakas, Konstantinos, Keane, Pearse A., Patel, Praveen J.
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container_issue 4
container_start_page 779
container_title Eye (London)
container_volume 37
creator Fu, Dun Jack
Hanumunthadu, Daren
Keenan, Tiarnan D. L.
Wagner, Siegfried
Balsakas, Konstantinos
Keane, Pearse A.
Patel, Praveen J.
description Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study of the Moorfields database of treatment-naïve nAMD eyes. Extraction criteria included at least 7 aflibercept injections in first year of treatment, AMD in the diagnosis field of EMR, and minimum of 1 year follow-up data. Results There were 2416 eyes of 2163 patients started on anti-vascular endothelial growth factor (anti-VEGF) between 01-11-2013 & 14-02-2020 who had received at least 7 aflibercept intravitreal injections (electronic database accessed March 2021). Of these, 1674 (68%) eyes of 1537 patients had at least one q12 dosing interval (>=84 and 
doi_str_mv 10.1038/s41433-022-02220-1
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L. ; Wagner, Siegfried ; Balsakas, Konstantinos ; Keane, Pearse A. ; Patel, Praveen J.</creator><creatorcontrib>Fu, Dun Jack ; Hanumunthadu, Daren ; Keenan, Tiarnan D. L. ; Wagner, Siegfried ; Balsakas, Konstantinos ; Keane, Pearse A. ; Patel, Praveen J.</creatorcontrib><description>Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study of the Moorfields database of treatment-naïve nAMD eyes. Extraction criteria included at least 7 aflibercept injections in first year of treatment, AMD in the diagnosis field of EMR, and minimum of 1 year follow-up data. Results There were 2416 eyes of 2163 patients started on anti-vascular endothelial growth factor (anti-VEGF) between 01-11-2013 &amp; 14-02-2020 who had received at least 7 aflibercept intravitreal injections (electronic database accessed March 2021). Of these, 1674 (68%) eyes of 1537 patients had at least one q12 dosing interval (&gt;=84 and &lt; =98 days between injections) during the first 2 years of treatment. This included 926 (61.8%) female patients and 856 (right eyes age at 1st injection), 936 (62.4%) Caucasian, and 32 (2.1%) Afro-Caribbean patients. The median time to the first q12 injection (95% confidence interval) was 1.76 years (1.70–1.86) with mean (±SD) of 11.8 (±6.0) injections. Visual acuity (ETDRS letters) of the eyes without q12 injection and eyes with a q12 injection was 57.9 ± 14.7 and 56.7 ± 14.8 respectively at baseline, 61.4 ± 18.1 and 63.0 ± 15.9 respectively at 12 months and 61.2 ± 20.1 and 61.1 ± 17.8 respectively at 24 months. Conclusion 68% of eyes were able to achieve a q12 injection dose within the first 2 years of treatment. Eyes achieving a q12 injection in the first 2 years achieved a similar visual acuity outcome at both 1 and 2-year follow-up to those unable to do so, with a fewer number of total injections.</description><identifier>ISSN: 0950-222X</identifier><identifier>EISSN: 1476-5454</identifier><identifier>DOI: 10.1038/s41433-022-02220-1</identifier><identifier>PMID: 36085360</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/53/2423 ; 692/699/3161/1626 ; Acuity ; Age ; Angiogenesis Inhibitors - therapeutic use ; Dosage ; Electronic medical records ; Eye ; Female ; Humans ; Infant ; Injection ; Intravitreal Injections ; Laboratory Medicine ; Macular degeneration ; Macular Degeneration - drug therapy ; Male ; Medicine ; Medicine &amp; Public Health ; Ophthalmology ; Patients ; Pharmaceutical Sciences/Technology ; Receptors, Vascular Endothelial Growth Factor ; Recombinant Fusion Proteins - therapeutic use ; Retrospective Studies ; Surgery ; Surgical Oncology ; Tertiary Care Centers ; Treatment Outcome ; Vascular endothelial growth factor ; Visual acuity ; Wet Macular Degeneration - diagnosis ; Wet Macular Degeneration - drug therapy</subject><ispartof>Eye (London), 2023-03, Vol.37 (4), p.779-784</ispartof><rights>The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2022. 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The Author(s), under exclusive licence to The Royal College of Ophthalmologists.</rights><rights>The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-b5caa057a282ed7c6ecc76f14b6f0cd83ee0651517b0de1cdfe8b1695652f76f3</citedby><cites>FETCH-LOGICAL-c474t-b5caa057a282ed7c6ecc76f14b6f0cd83ee0651517b0de1cdfe8b1695652f76f3</cites><orcidid>0000-0002-9239-745X ; 0000-0002-2253-1772 ; 0000-0001-8682-4067 ; 0000-0003-2852-6912</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998641/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998641/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36085360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fu, Dun Jack</creatorcontrib><creatorcontrib>Hanumunthadu, Daren</creatorcontrib><creatorcontrib>Keenan, Tiarnan D. L.</creatorcontrib><creatorcontrib>Wagner, Siegfried</creatorcontrib><creatorcontrib>Balsakas, Konstantinos</creatorcontrib><creatorcontrib>Keane, Pearse A.</creatorcontrib><creatorcontrib>Patel, Praveen J.</creatorcontrib><title>Characterising treatment outcomes of patients achieving quarterly aflibercept dosing for neovascular age-related macular degeneration: real-world clinical outcomes from a large tertiary care centre</title><title>Eye (London)</title><addtitle>Eye</addtitle><addtitle>Eye (Lond)</addtitle><description>Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study of the Moorfields database of treatment-naïve nAMD eyes. Extraction criteria included at least 7 aflibercept injections in first year of treatment, AMD in the diagnosis field of EMR, and minimum of 1 year follow-up data. Results There were 2416 eyes of 2163 patients started on anti-vascular endothelial growth factor (anti-VEGF) between 01-11-2013 &amp; 14-02-2020 who had received at least 7 aflibercept intravitreal injections (electronic database accessed March 2021). Of these, 1674 (68%) eyes of 1537 patients had at least one q12 dosing interval (&gt;=84 and &lt; =98 days between injections) during the first 2 years of treatment. This included 926 (61.8%) female patients and 856 (right eyes age at 1st injection), 936 (62.4%) Caucasian, and 32 (2.1%) Afro-Caribbean patients. The median time to the first q12 injection (95% confidence interval) was 1.76 years (1.70–1.86) with mean (±SD) of 11.8 (±6.0) injections. Visual acuity (ETDRS letters) of the eyes without q12 injection and eyes with a q12 injection was 57.9 ± 14.7 and 56.7 ± 14.8 respectively at baseline, 61.4 ± 18.1 and 63.0 ± 15.9 respectively at 12 months and 61.2 ± 20.1 and 61.1 ± 17.8 respectively at 24 months. Conclusion 68% of eyes were able to achieve a q12 injection dose within the first 2 years of treatment. 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L.</creatorcontrib><creatorcontrib>Wagner, Siegfried</creatorcontrib><creatorcontrib>Balsakas, Konstantinos</creatorcontrib><creatorcontrib>Keane, Pearse A.</creatorcontrib><creatorcontrib>Patel, Praveen J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Eye (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fu, Dun Jack</au><au>Hanumunthadu, Daren</au><au>Keenan, Tiarnan D. L.</au><au>Wagner, Siegfried</au><au>Balsakas, Konstantinos</au><au>Keane, Pearse A.</au><au>Patel, Praveen J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterising treatment outcomes of patients achieving quarterly aflibercept dosing for neovascular age-related macular degeneration: real-world clinical outcomes from a large tertiary care centre</atitle><jtitle>Eye (London)</jtitle><stitle>Eye</stitle><addtitle>Eye (Lond)</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>37</volume><issue>4</issue><spage>779</spage><epage>784</epage><pages>779-784</pages><issn>0950-222X</issn><eissn>1476-5454</eissn><abstract>Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study of the Moorfields database of treatment-naïve nAMD eyes. Extraction criteria included at least 7 aflibercept injections in first year of treatment, AMD in the diagnosis field of EMR, and minimum of 1 year follow-up data. Results There were 2416 eyes of 2163 patients started on anti-vascular endothelial growth factor (anti-VEGF) between 01-11-2013 &amp; 14-02-2020 who had received at least 7 aflibercept intravitreal injections (electronic database accessed March 2021). Of these, 1674 (68%) eyes of 1537 patients had at least one q12 dosing interval (&gt;=84 and &lt; =98 days between injections) during the first 2 years of treatment. This included 926 (61.8%) female patients and 856 (right eyes age at 1st injection), 936 (62.4%) Caucasian, and 32 (2.1%) Afro-Caribbean patients. The median time to the first q12 injection (95% confidence interval) was 1.76 years (1.70–1.86) with mean (±SD) of 11.8 (±6.0) injections. Visual acuity (ETDRS letters) of the eyes without q12 injection and eyes with a q12 injection was 57.9 ± 14.7 and 56.7 ± 14.8 respectively at baseline, 61.4 ± 18.1 and 63.0 ± 15.9 respectively at 12 months and 61.2 ± 20.1 and 61.1 ± 17.8 respectively at 24 months. Conclusion 68% of eyes were able to achieve a q12 injection dose within the first 2 years of treatment. Eyes achieving a q12 injection in the first 2 years achieved a similar visual acuity outcome at both 1 and 2-year follow-up to those unable to do so, with a fewer number of total injections.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>36085360</pmid><doi>10.1038/s41433-022-02220-1</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-9239-745X</orcidid><orcidid>https://orcid.org/0000-0002-2253-1772</orcidid><orcidid>https://orcid.org/0000-0001-8682-4067</orcidid><orcidid>https://orcid.org/0000-0003-2852-6912</orcidid><oa>free_for_read</oa></addata></record>
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source MEDLINE; PubMed Central; SpringerLink Journals - AutoHoldings
subjects 692/53/2423
692/699/3161/1626
Acuity
Age
Angiogenesis Inhibitors - therapeutic use
Dosage
Electronic medical records
Eye
Female
Humans
Infant
Injection
Intravitreal Injections
Laboratory Medicine
Macular degeneration
Macular Degeneration - drug therapy
Male
Medicine
Medicine & Public Health
Ophthalmology
Patients
Pharmaceutical Sciences/Technology
Receptors, Vascular Endothelial Growth Factor
Recombinant Fusion Proteins - therapeutic use
Retrospective Studies
Surgery
Surgical Oncology
Tertiary Care Centers
Treatment Outcome
Vascular endothelial growth factor
Visual acuity
Wet Macular Degeneration - diagnosis
Wet Macular Degeneration - drug therapy
title Characterising treatment outcomes of patients achieving quarterly aflibercept dosing for neovascular age-related macular degeneration: real-world clinical outcomes from a large tertiary care centre
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