Abstract
Purpose :
This study investigates the impact of anti-VEGF treatment frequency and pattern on long-term VA outcomes in real-world nAMD patients in the U.S..
Methods :
A retrospective cohort study was conducted using the de-identified Vestrum Health EHR database. Patients who were newly diagnosed with nAMD between Jan 2015-Mar 2019, ≥50 years old, had ≥12-month follow-up, and received ≥1 anti-VEGF treatment were included. The primary outcome was change in VA over 48 months. Changes in VA were evaluated across subgroups defined by: baseline VA, first year treatment frequency, and anti-VEGF induction, defined as first 3 injections within 4 months of diagnosis. VA scores were converted from Snellen to ETDRS equivalent letters.
Results :
We identified 40,094 patients with newly diagnosed nAMD. Mean age was 80 years and 62.7% were female. The mean baseline VA (SD) was 50.2 (23.9) ETDRS letters; 28% had baseline VA ≤35 letters (≤20/200), 22% had 57-36 letters (20/70-20/200), 29% had 69-58 letters (20/70-20/40), and 22% had ≥70 letters (≥20/40). At 12, 24, 36, and 48 months, patients received an average of 7.7, 6.0, 5.7 and 5.5 injections each year and had a mean VA change from baseline of +4.5, +3.4, +1.7, and +1.1 letters respectively.
VA change was associated with a greater number of injections. Given similar injection frequency, patients with worse baseline VA had larger VA gain compared to those with better baseline VA (Figure 1). Additionally, patients who underwent induction with 3 monthly anti-VEGF doses had higher annual treatment frequency over time and corresponding better short- and long-term visual outcomes (Figure 2).
Conclusions :
In the US, based on a large real-world dataset of treatment naive nAMD patients, better short- and long-term VA outcomes are associated with lower baseline VA, higher treatment frequency, and anti-VEGF induction with 3 injections within 4 months of diagnosis.
This is a 2021 ARVO Annual Meeting abstract.