June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A Pharmacoepidemiological study of intravitreal drug consumption in the first 12 months of treatment. The EPIdemiology and SAFEty collaboration.
Author Affiliations & Notes
  • Vincent Daien
    Ophthalmology, CHU Montpelliler, Saint Gely Du Fesc, France
  • Catherine P Creuzot Garcher
    CHU Dijon, Dijon, France
  • Marie-Noëlle Delyfer
    Ophtalmologie, CHU BORDEAUX, Bordeaux, France
  • Alain M Bron
    CHU Dijon, Dijon, France
  • Mark C Gillies
    Save Sight Institute, SYDNEY, New South Wales, Australia
  • Sandy Lacombe
    Statistiques, IURC, Montpellier, France
  • Laurence Papinaud
    ERSM, Montpellier, France
  • Dominique Cholley
    ERSM, Montpellier, France
  • Caroline Domerg
    ERSM, Montpellier, France
  • Audrey Cougnard-Gregoire
    Bordeaux University, Bordeaux, France
  • Catherine Quantin
    CHU Dijon, Dijon, France
  • Max Villain
    Ophthalmology, CHU Montpelliler, Saint Gely Du Fesc, France
  • Jean Pierre Daures
    Statistiques, IURC, Montpellier, France
  • Cecile DelCourt
    Bordeaux University, Bordeaux, France
  • Jean-Francois Korobelnik
    Ophtalmologie, CHU BORDEAUX, Bordeaux, France
  • Footnotes
    Commercial Relationships   Vincent Daien, ALCON (C), BAYER (C), NOVARTIS (R), THEA (C); Catherine Creuzot Garcher, Alcon (F), Allergan (F), Baush & Lomb (I), Bayer (F), Horus (F), Novartis (F), Thea (F); Marie-Noëlle Delyfer, Allergan (F), Bayer (F), Carl Zeiss Meditec (F), Novartis (F), Thea (F); Alain Bron, Allergan (F), Bausch Lomb (F), Horus (F), Théa (F); Mark Gillies, ALLERGAN (C), BAYER (C), NOVARTIS (C), OPHTEA (C); Sandy Lacombe, None; Laurence Papinaud, None; Dominique Cholley, None; Caroline Domerg, None; Audrey Cougnard-Gregoire, None; Catherine Quantin, None; Max Villain, Allergan (F); Jean Pierre Daures, None; Cecile DelCourt, Allergan (F), Bausch Lomb (F), Novartis (F), Roche (F), Thea (F); Jean-Francois Korobelnik, Alimera (F), Allergan (F), Bayer (F), Carl Zeiss Meditech (F), NOVARTIS (F), Roche (F)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2017, Vol.58, 902. doi:
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      Vincent Daien, Catherine P Creuzot Garcher, Marie-Noëlle Delyfer, Alain M Bron, Mark C Gillies, Sandy Lacombe, Laurence Papinaud, Dominique Cholley, Caroline Domerg, Audrey Cougnard-Gregoire, Catherine Quantin, Max Villain, Jean Pierre Daures, Cecile DelCourt, Jean-Francois Korobelnik; A Pharmacoepidemiological study of intravitreal drug consumption in the first 12 months of treatment. The EPIdemiology and SAFEty collaboration.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):902.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report the 12-month consumption of intravitreal therapies with vascular endothelial growth factor (VEGF) inhibitors (aflibercept or ranibizumab) and dexamethasone implants in a region of France.

Methods : The study sample consisted of 2814 adults, assessed from the medico-administrative database which includes 2.7 million inhabitants from Languedoc Roussillon, a region of the South-East of France (Données de consommation inter-régimes [DCIR]). Patients were included in this study if they had not received any intravitreal therapy for at least 18 months, were treated for one eye, and if they received > 1 intravitreal injection after inclusion in the study, over a 12-month period between 1st July 2014 and 31st of August 2016.

Results : Mean (standard deviation) age of the population was 76.1 (11) years, 57.6% were female, 26.6% were being treated for diabetes, 65.5% for hypertension, 32.7% for dyslipidemia and 5.8% had a history of cardiovascular disease.
Among 748 diabetic patients, 86.4% received only VEGF inhibitors, 2.7% only dexamethasone implants and 10.8% a combination of dexamethasone implants and VEGF inhibitors over the 12-month period. Among diabetic patients treated exclusively with VEGF inhibitors, the median (interquartile range [IQR]) number of delivered drugs in the 12 first months was 5 (4-7) while in those treated only with dexamethasone implants, it was 3 (2-4).
Among 2066 non-diabetic patients, 90.7% received only VEGF inhibitors drugs, 4.3% only dexamethasone implants and 5.0% and combination of dexamethasone implants and VEGF inhibitors; the median (IQR) number of VEGF inhibitor agents delivered in the first 12 months of therapy was 5 (3-7).

Conclusions : A median number of 5 delivered VEGF inhibitors in the 12 first months of therapy observed from medico-administrative database was in the range of the number of intravitreal injections from previous observational studies. This is lower than the number of intravitreal drug delivered in the 12 first months in randomized controlled trials for diabetic macular edema (between 9 and 10) and nAMD (between 7 and 12) where best outcomes were achieved. Analysis of the medico-administrative database appears to be a useful way to assess the consumption of intravitreal drugs in real world clinical practice in France. Patients with retinal disease may be undertreated in real world practice.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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