Characteristics and Treatment Patterns of Patients with Diabetic Macular Edema Non-Responsive to Anti-Vascular Endothelial Growth Factor Treatment in Ontario, Canada.

Autor: Somani S; Department of Ophthalmology and Vision Sciences, University of Toronto and Uptown Eye Specialists, Brampton, Canada., Koushan K; Toronto Retina Institute, Toronto, Canada., Shah-Manek B; Health Economics and Outcomes Research, Noesis Healthcare Technologies, Inc., Redwood City, CA, USA., Mercer D; Genesis Research, Hoboken, NJ, USA., Kanagenthiran T; Allergan, an AbbVie Company, Irvine, CA, USA., Zhao C; Allergan, an AbbVie Company, Irvine, CA, USA., Alobaidi A; Allergan, an AbbVie Company, Irvine, CA, USA.
Jazyk: angličtina
Zdroj: Clinical ophthalmology (Auckland, N.Z.) [Clin Ophthalmol] 2023 Jul 17; Vol. 17, pp. 2013-2025. Date of Electronic Publication: 2023 Jul 17 (Print Publication: 2023).
DOI: 10.2147/OPTH.S399981
Abstrakt: Purpose: To understand the demographics, clinical characteristics, treatment patterns, visual and anatomic responses of patients with diabetic macular edema (DME) initially treated with anti-vascular endothelial growth factor (anti-VEGF) agents in the real-world clinical setting.
Patients and Methods: This retrospective cohort study used electronic health records to identify consecutively presenting patients with DME who received their first documented anti-VEGF injection (index injection) on or after 1 October 2015 and before 30 September 2016 (index period) at 4 clinical sites in Ontario, Canada. Patients receiving anti-VEGF injections in the study eye were followed for ≥18 months. After the first 3 monthly injections, patients were classified as "responder" (≥20% reduction in central retinal thickness [CRT] from index date) or "nonresponder" (<20% reduction in CRT) to anti-VEGF treatment.
Results: At 12 months, change from baseline (CFB) in best visual acuity (BVA) of responders (n = 30) was mean (SD) 12.8 (13.00) letters; CFB in nonresponders (n = 56) was 3.2 (16.3) letters. Sensitivity analyses stratified by initial BVA were supportive. Mean (SD) change in CRT (μm) was -160.4 (111.4) in responders and -62.2 (98.6) in nonresponders. While changes in anti-VEGF therapy were lower in responders versus nonresponders (10.0% vs 23.2%), mean number of injections was similar (8.3 in each cohort).
Conclusion: Despite receiving a substantial number of injections and requiring changes in therapy more frequently, nonresponders showed a lack of clinically meaningful change in BVA and CRT. Nonresponders could be identified after 3 anti-VEGF injections. There remains an unmet need for treatment options in patients with DME who show a nonresponse after 3 months of anti-VEGF treatment.
Competing Interests: Financial arrangements of the authors with companies whose products may be related to the present report are listed as declared by the authors: SS has served as a speaker for AbbVie, Bayer, and Novartis, and a consultant for Bayer, Novartis, and Ripple Therapeutics. KK has served as a consultant to Alcon, Allergan (an AbbVie company), Bayer, Novartis, and received a research grant from Bayer. BS-M serves as a consultant for AbbVie and is an employee of Noesis Healthcare Technologies. DM is a consultant for AbbVie and is an employee of Genesis Research. TK, CZ, and AA are full-time employees of AbbVie and may own AbbVie stock/share options. The authors report no other conflicts of interest in this work.
(© 2023 Somani et al.)
Databáze: MEDLINE
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