June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Characterizing Long-term Vision Change and Intravitreal Anti-VEGF Treatment Pattern Among Neovascular Age-Related Macular Degeneration (nAMD) Patients in the US: Analysis of the Vestrum Database
Author Affiliations & Notes
  • Cecile Truong
    Genentech Inc, South San Francisco, California, United States
  • Glenn Yiu
    Ophthalmology, University of California Davis, Davis, California, United States
  • Shih-Chen Chang
    Genentech Inc, South San Francisco, California, United States
  • Jeffrey Willis
    Genentech Inc, South San Francisco, California, United States
  • Nicholas Boucher
    Vestrum Health, Illinois, United States
  • Fabio Ishii
    Vestrum Health, Illinois, United States
  • Kemal Asik
    Genentech Inc, South San Francisco, California, United States
  • Priya Kulkarni
    Genentech Inc, South San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Cecile Truong, Genentech (E); Glenn Yiu, Allergan (C), Carl Zeiss Meditec (C), Clearside (C), Genentech (C), Intergalactic Therapeutics (C), Iridex (C), Regeneron (C), Topcon (C), Verily (C); Shih-Chen Chang, Genentech (E); Jeffrey Willis, Genentech (E); Nicholas Boucher, Vestrum Health (E); Fabio Ishii, Vestrum Health (E); Kemal Asik, Genentech (E); Priya Kulkarni, Genentech (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 422. doi:
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      Cecile Truong, Glenn Yiu, Shih-Chen Chang, Jeffrey Willis, Nicholas Boucher, Fabio Ishii, Kemal Asik, Priya Kulkarni; Characterizing Long-term Vision Change and Intravitreal Anti-VEGF Treatment Pattern Among Neovascular Age-Related Macular Degeneration (nAMD) Patients in the US: Analysis of the Vestrum Database. Invest. Ophthalmol. Vis. Sci. 2021;62(8):422.

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

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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.

 

Figure 1. Change in VA By Baseline VA and First Year Treatment Frequency. 95% CI are indicated for mean VA change.

Figure 1. Change in VA By Baseline VA and First Year Treatment Frequency. 95% CI are indicated for mean VA change.

 

Figure 2. Mean VA Change from Baseline by Receiving 3 anti-VEGF Induction Injections Within 4 Months of Diagnosis. Numbers indicate (mean VA change from baseline, median injections per year, cohort size). 95% CI are indicated for mean VA change.

Figure 2. Mean VA Change from Baseline by Receiving 3 anti-VEGF Induction Injections Within 4 Months of Diagnosis. Numbers indicate (mean VA change from baseline, median injections per year, cohort size). 95% CI are indicated for mean VA change.

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