Treatment outcomes and predicting factors for diabetic macular edema treated with ranibizumab – One-year real-life results in Taiwan

Lai, Tso‐Ting; Yang, Chung-May; Ho, Tzyy‐Chang; Hsieh, Yi‐Ting

doi:10.1016/j.jfma.2018.03.009

Cited by 19 publications

(39 citation statements)

References 26 publications

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“…5 Suboptimal results with fewer injections were also reported in subsequent real-world studies conducted on different diseases, such as DME 6,7 and RVO. 8 However, results comparable to those in clinical trials were found when similar treatment schedules were used in AMD and DME. 9,10…”

Section: Introductionsupporting

confidence: 54%

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Use of anti-vascular endothelial growth factor drugs for eye disease in Tuscany: Development and test of indicators of treatment intensity

Virgili

Tosi

Figus

et al. 2019

European Journal of Ophthalmology

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Purpose: We aimed to develop indicators based on electronic administrative data to compare treatment intensity at a hospital level in Tuscany, Italy. Methods: Data from 3 university hospitals (UHs), 11 local hospitals (LHs) and 2 private hospitals were analysed. Patients newly treated with an intravitreal injection were followed up for 365 days. Indicator #1 concerned hospitals with >80% of injections linked to a drug and patients with all injections linked to a drug. Indicator #2 included patients who received ⩾3 injections during the first 90 days, regardless of injection-drug linkage. Results: Indicator #1 was computed on four hospitals and included 3210 patients (48.3%). The average number of injections was 3.24 in the largest UH1. Compared to the latter, indicator #1 was significantly lower in UH2 and UH3 (−0.47 and −0.58, respectively; p < 0.001). Indicator #2 was computed on all hospitals and included 2789 patients (41.9%). UH1 delivered about 4.33 injections. Compared to the latter, LH4 delivered +0.62 injections ( p < 0.001) and nine other hospitals delivered between −0.22 and −0.94 injections ( p < 0.05). Conclusion: The two indicators proved to have the potential for supporting clinicians and policy makers in promoting the appropriate treatment intensity with intravitreal anti-vascular endothelial growth factor drugs.

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Section: Introductionsupporting

confidence: 54%

“…Nonetheless, the evidence on the relationship between average treatment intensity and average visual outcomes at the centre level is substantial. 4,5,8,9…”

Section: Rationale For the Two Indicatorsmentioning

confidence: 99%

Use of anti-vascular endothelial growth factor drugs for eye disease in Tuscany: Development and test of indicators of treatment intensity

Virgili

Tosi

Figus

et al. 2019

European Journal of Ophthalmology

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“…These findings are consistent with previous analyses of real-world anti-VEGF treatment patterns, which have similarly reported average 12-month injection frequencies of 4.3-5.8 and 2.2-4.4 among patients with nAMD and DME, respectively. 24,25,[33][34][35][36][37][38] Our results also agree with American Society of Retina Specialists Preferences and Trends Surveys, which suggest that most retina specialists prefer to administer ongoing treatment according to anatomic findings observed on follow-up optical coherence tomography (e.g., subfoveal retinal thickness and central subfield thickness), rather than FDA labeling. 21,22 However, these findings are not intended to suggest that real-world injection frequencies reflect patient need or response to therapy.…”

Section: Real-world Dosing Versus Labeled Injection Schedulessupporting

confidence: 84%

Real-World Injection Frequency and Cost of Ranibizumab and Aflibercept for the Treatment of Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema

Kiss

Malangone-Monaco

Wilson

et al. 2020

JMCP

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BACKGROUND: Ranibizumab and aflibercept are FDA-approved treatments for patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). Although these agents differ in cost and labeled dosing, it is unclear whether these differences are reflected in clinical practice.OBJECTIVE: To compare the real-world frequency and cost of ranibizumab and aflibercept injections among treatment-naive and previously treated patients with nAMD and DME.METHODS: Claims data from MarketScan Research Databases were retrospectively reviewed to identify treatment-naive patients with nAMD who initiated intravitreal ranibizumab or aflibercept between

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“…Moreover, the greatest increases in both BCVA and CRT were observed after 3 monthly loading injections. Protocol I from Diabetic Retinopathy Clinical Research (DRCR) and research by Lai et al had similar results in demonstrating that BCVA restoration after the 3 monthly injections was predictive of long-term visual benefits (12,17).…”

Section: Discussionmentioning

confidence: 82%

“…Despite robust findings from clinical trials, around half of eyes do not fully respond to anti-VEGF (9), and further exploration of prognostic factors associated with better visual outcomes is warranted. Age, HbA1c status, central retinal thickness (CRT) have been investigated but to mixed results (10)(11)(12)(13). Moreover, little is known regarding how optical coherence tomography (OCT) biomarkers including epiretinal membrane (ERM) and ellipsoid zone disruption (EZD) affect the resolution of macular edema and final vision, and its implication for therapeutic strategy.…”

Section: Introductionmentioning

confidence: 99%

Age, Initial Central Retinal Thickness, and OCT Biomarkers Have an Influence on the Outcome of Diabetic Macular Edema Treated With Ranibizumab– Tri-center 12-Month Treat-and-Extend Study

et al. 2021

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Objective: We report the tri-center 1-year outcomes of a treat-and-extend (T&E) regimen in four-week intervals with ranibizumab for diabetic macular edema (DME).Methods: In this retrospective study, all eyes received 3 monthly loading injections of 0.5 mg ranibizumab, followed by a T&E regimen for DME. Regression models were used to evaluate the associating factors for visual and anatomical outcomes.Results: Ninety one eyes from 64 patients were enrolled. Mean LogMAR best-corrected visual acuity (BCVA) improved from 0.58 at baseline to 0.36 at month 12 and mean central retinal thickness (CRT) decreased from 411 μm at baseline to 290 μm at month 12. Younger age and eyes having thinner baseline CRT, with ellipsoid zone disruption (EZD), and without epiretinal membrane (ERM) were associated with better final CRT. Moreover, eyes with thicker baseline CRT tend to receive more injections. Among the parameters, only having ERM or EZD was associated with significant BCVA recovery.Conclusions: A T&E regimen with ranibizumab by 4-week intervals is effective in improving BCVA and reducing CRT with efficacy notable starting from the third month. Clinical parameters including age, initial CRT, and presence of ERM or EZD significantly influenced therapeutic outcomes. Moreover, the presence of ERM should not preclude DME patients from receiving anti-VEGF therapy. Future studies with larger cohorts are warranted.

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Treatment outcomes and predicting factors for diabetic macular edema treated with ranibizumab – One-year real-life results in Taiwan

Cited by 19 publications

References 26 publications

Use of anti-vascular endothelial growth factor drugs for eye disease in Tuscany: Development and test of indicators of treatment intensity

Use of anti-vascular endothelial growth factor drugs for eye disease in Tuscany: Development and test of indicators of treatment intensity

Real-World Injection Frequency and Cost of Ranibizumab and Aflibercept for the Treatment of Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema

Age, Initial Central Retinal Thickness, and OCT Biomarkers Have an Influence on the Outcome of Diabetic Macular Edema Treated With Ranibizumab– Tri-center 12-Month Treat-and-Extend Study

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