Evolution of treatment paradigms in neovascular age-related macular degeneration: a review of real-world evidence

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Daien V., Finger R. P., Talks J. S., Mitchell P., Wong T. Y., Sakamoto T., ...More

BRITISH JOURNAL OF OPHTHALMOLOGY, vol.105, no.11, pp.1475-1479, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 105 Issue: 11
  • Publication Date: 2021
  • Doi Number: 10.1136/bjophthalmol-2020-317434
  • Journal Name: BRITISH JOURNAL OF OPHTHALMOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.1475-1479
  • Keywords: Epidemiology, Macula, Neovascularisation, Retina, Vision, VISUAL-ACUITY OUTCOMES, GROWTH-FACTOR THERAPY, EXTEND INTRAVITREAL THERAPY, ANTI-VEGF TREATMENT, 2-YEAR OUTCOMES, CHOROIDAL NEOVASCULARIZATION, BASE-LINE, AFLIBERCEPT, RANIBIZUMAB, REGIMEN
  • Hacettepe University Affiliated: Yes

Abstract

The aim of this work was to evaluate the contribution of real-world evidence (RWE) in changing anti-vascular endothelial growth factor (VEGF) therapy treatment practices and improving real-world treatment strategies for neovascular age-related macular degeneration (nAMD). A PubMed literature search was performed to review the large number of English-language studies conducted to investigate the real-world effectiveness of anti-VEGF (aflibercept and ranibizumab) treatment paradigms available for nAMD. The evidence for pro re nata (PRN), treat-and-extend (T&E) and fixed bimonthly dosing regimens for anti-VEGF treatment of nAMD were reviewed and findings are summarised. RWE demonstrated that T&E regimens optimise visual outcomes while reducing burden on patients, clinics and physicians, compared with both fixed-dose and PRN regimens. RWE has helped to develop and improve real-world treatment strategies in nAMD, with the aim of optimising visual outcomes and reducing treatment burden in clinical practice. Of the various regimens, a T&E regimen is most likely to adequately balance clinical outcomes and treatment burden for patients with nAMD.