June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Characteristics and outcomes of patients with nAMD managed in US routine clinical practice
Author Affiliations & Notes
  • anita barikian
    East Florida Eye Institute, Stuart, Florida, United States
  • Jaya Badhwar Kumar
    Florida Retina Institute, Orlando, Florida, United States
  • April McCullough
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • Fabiana Q Silva
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • Steven Sherman
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • Hadi Moini
    Regeneron Pharmaceuticals Inc, Tarrytown, New York, United States
  • Rishi P Singh
    Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   anita barikian None; Jaya Badhwar Kumar Alimera, Code C (Consultant/Contractor); April McCullough Regeneron Pharmaceuticals, Inc., Code E (Employment); Fabiana Silva Regeneron Pharmaceuticals, Inc., Code E (Employment); Steven Sherman Regeneron Pharmaceuticals, Inc., Code E (Employment); Hadi Moini Regeneron Pharmaceuticals, Inc., Code E (Employment); Rishi Singh Genentech/Roche, Alcon, Novartis, Zeiss, Bausch & Lomb, Gyroscope, Asclepix, Regeneron Pharmaceuticals, Code C (Consultant/Contractor), Apellis, NGM Biopharma , Code F (Financial Support)
  • Footnotes
    Support  Regeneron Pharmaceuticals, Inc.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3530. doi:
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      anita barikian, Jaya Badhwar Kumar, April McCullough, Fabiana Q Silva, Steven Sherman, Hadi Moini, Rishi P Singh; Characteristics and outcomes of patients with nAMD managed in US routine clinical practice. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3530.

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

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Abstract

Purpose : To evaluate the management of nAMD, visual outcomes at 1 year, factors predicting sufficient treatment, and the impact of treatment sufficiency on visual outcomes in routine clinical practice.

Methods : This retrospective analysis of the Intelligent Research in Sight (IRIS)® registry included treatment-naïve eyes diagnosed with nAMD between Jan 2013 and Dec 2019 with best-corrected visual acuity (BCVA) ≥20/400, anti-VEGF treatment within 3 months of diagnosis, and 1 year of follow-up. Eyes were considered sufficiently or insufficiently treated if they received ≥7 or <7 anti-VEGF injections in Year 1, respectively. Logistic regression identified factors associated with visual outcomes and treatment sufficiency, and the impact of treatment sufficiency on BCVA.

Results : Of 295,561 eligible eyes, 206,517 eyes were treated and 88,990 eyes were not actively treated. Of 184,258 treated patient-eyes, 109,696 (59.5%) received sufficient and 74,562 (40.5%) insufficient treatment. Baseline characteristics were largely comparable across treated groups; mean baseline BCVA was ~61 letters. Mean number of injections was 8.9 vs 4.0 with sufficient vs insufficient treatment, respectively. Asian, African American, Hispanic; Medicaid insured; or non-retina specialist treated patients were less likely to receive sufficient treatment (all P<0.001). Mean BCVA change from baseline at 1 year was significantly greater with sufficient vs insufficient treatment (3.5 vs –0.3 letters; P<0.0001), with larger gains in eyes with baseline BCVA of 20/100-20/200 (10.2 vs 3.1 letters) and <20/200-≥20/400 (19.9 vs 8.9 letters). Sufficiently treated eyes had higher odds of gaining ≥15-letters (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.6, 1.7) and lower odds of losing ≥15-letters (OR, 0.7; 95% CI, 0.6, 0.7) compared to insufficiently treated eyes. Older age, Medicaid insured, and/or better BCVA were associated with worse visual outcomes in both sufficiently and insufficiently treated eyes (all P<0.05).

Conclusions : A substantial number of eyes diagnosed with nAMD were insufficiently treated over 1 year, with worse visual outcomes compared with sufficiently treated eyes. Patient race, ethnicity, insurance type, and treating physician speciality impacted nAMD management. Such findings can identify gaps in care leading to suboptimal outcomes during management of nAMD.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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