Treatment Frequency and Dosing Interval of Ranibizumab and Aflibercept for Neovascular Age-Related Macular Degeneration in Routine Clinical Practice in the USA

Abstract

PurposeTo compare treatment patterns of intravitreal ranibizumab and aflibercept for the management of neovascular age-related macular degeneration (nAMD) in a real-world setting over the first 12 months of treatment.MethodsA proprietary clinical database was used to identify treatment-naïve patients with nAMD in the USA with claims for ranibizumab or aflibercept between November 1, 2011 and November 30, 2013 and with follow-up of at least 12 months. Patients were considered treatment-naïve if they had no anti-VEGF treatment code for 6 months before the index date. Mean numbers of injections and of non-injection visits to a treating physician were compared between the two treatment cohorts (ranibizumab or aflibercept). In addition, the mean interval between doses was also investigated.ResultsPatient characteristics were similar for those receiving either ranibizumab (n = 5421) or aflibercept (n = 3506) at the index date. The mean (± standard deviation) numbers of injections received by patients treated with ranibizumab (4.9 ± 3.3) or aflibercept (5.2 ± 2.9) were not clinically different. The mean number of non-injection visits was 2.8 ± 2.8 and 2.1 ± 2.5 for ranibizumab and aflibercept, respectively. Mean dosing interval was 51.0 days (± 41.8 days) in patients receiving ranibizumab and 54.1 days (± 36.0 days) in those receiving aflibercept. Results were robust to sensitivity analyses for definition of treatment-naïve, length of follow-up and treatment in the index eye only.ConclusionsLimited data exist regarding real-world treatment patterns of aflibercept for the management of nAMD. Our results suggest that, in routine clinical practice, patients receive a comparable number of injections in the first year of treatment with ranibizumab or aflibercept.

Neovascular age‐related macular degeneration treated with ranibizumab or aflibercept in the same large clinical setting: visual outcome and number of injections

“…) and dosing interval or number of visits are also similar (Ferreira et al. ). The design of the studies leaves space for further exploration.…”

“…The few studies comparing ranibizumab and aflibercept include ones based on administrative claims data (Ferreira et al. ; Schmid et al. ), a Bayesian network meta‐analysis of a systematic literature review (Szabo et al.…”

Aflibercept as First-Line Therapy in Patients with Treatment-Naïve Neovascular Age-Related Macular Degeneration: Prospective Case Series Analysis in Real-Life Clinical Practice

“…Our study, which was carried out in routine daily practice, confirms optimal vision gains and anatomic disease control previously reported in two large clinical trials involving more than 2,400 patients with nvAMD [25] as well as in the 96-week extension of these trials [26]. Also, a number of observational studies have shown the beneficial effect of aflibercept therapy for nvAMD in both resistant to other VEGF inhibitors (bevacizumab and ranibizumab) [27,28,29,31,32] and as first line in clinical practice [33,34]. …”

Understanding lymphangiogenesis in knockout models, the cornea, and ocular diseases for the development of therapeutic interventions

“…261 However, a recent study comparing aflibercept and ranibizumab treatment patterns for AMD showed that the number of injections patients receive is comparable in the first year of treatment with aflibercept or ranibizumab; this may render the previously reported aflibercept-associated benefits of a decreased treatment and compliance burden and injection-related risks inapplicable. 262 In another study, aflibercept was found to have greater efficacy for improving visual acuity in patients with diabetic macular edema in comparison to bevacizumab and ranibizumab, while also allowing for a greater interval of time between injections. 263 The FDA has approved aflibercept under the trade name Eylea for the treatment of wet AMD and diabetic retinopathy in patients with diabetic macular edema.…”