Barthelmes Daniel, Nguyen Vuong, Walton Richard, Gillies Mark C, Daien Vincent
Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Graefes Arch Clin Exp Ophthalmol. 2018 Oct;256(10):1839-1846. doi: 10.1007/s00417-018-4061-2. Epub 2018 Jul 27.
To report 12-month pharmacoepidemiologic data on aflibercept and ranibizumab use in treatment-naïve eyes with neovascular age-related macular degeneration (nAMD).
Participants were treatment-naïve eyes with nAMD tracked by the Fight Retinal Blindness! registry starting therapy with aflibercept or ranibizumab treatment between January 1st, 2013 and 31st December, 2016. Demographic and clinical characteristics were compared between treatment groups.
During the study period, 689 eyes initiated treatment with ranibizumab compared to 568 with aflibercept. We found a similar rate of use of both drugs. Ranibizumab-treated patients were older than aflibercept-treated patients (overall mean [SD] 82.0 [8.4] vs. 78.6 [8.1], P < 0.001). Median (Q1, Q3) lesion size was significantly larger in aflibercept-treated patients (2450 μm [1242, 3000]) compared with ranibizumab patients (2000 μm [1148, 2890], P = 0.008). Eyes treated with ranibizumab and aflibercept received a similar mean number of injections in the first 3 months (3.1 [0.7] vs. 3.0 [0.6]; P = 0.233) and at 12 months (7.3 [2.4] vs. 7.2 [2.2]; P = 0.139). The 12-month switching rates from 2013 onwards for eyes completing 12 months of follow-up were much higher for switching from ranibizumab to aflibercept (19.2%) compared with switching from aflibercept to ranibizumab (5.4%). The proportion of eyes that did not complete 12 months of treatment was 23.2% for ranibizumab and 22.2% for aflibercept-treated groups.
A similar rate of use for ranibizumab and aflibercept among Australian practitioners was observed between 2013 and 2016. Ranibizumab was used more often in older patients while aflibercept tended to be used more often in eyes with larger lesions.
报告阿柏西普和雷珠单抗用于初治新生血管性年龄相关性黄斑变性（nAMD）患眼的12个月药物流行病学数据。
参与者为初治nAMD患眼，通过“抗击视网膜失明！”登记系统进行跟踪，于2013年1月1日至2016年12月31日期间开始接受阿柏西普或雷珠单抗治疗。比较治疗组之间的人口统计学和临床特征。
在研究期间，689只眼开始接受雷珠单抗治疗，而568只眼接受阿柏西普治疗。我们发现两种药物的使用比例相似。接受雷珠单抗治疗的患者比接受阿柏西普治疗的患者年龄更大（总体均值[标准差]82.0[8.4]对78.6[8.1]，P<0.001）。与雷珠单抗治疗的患者（2000μm[1148,2890]）相比，接受阿柏西普治疗的患者的病变大小中位数（四分位数间距）显著更大（2450μm[1242,3000]，P=0.008）。接受雷珠单抗和阿柏西普治疗的患眼在最初3个月内平均注射次数相似（3.1[0.7]对3.0[0.6]；P=0.233），在12个月时也是如此（7.3[2.4]对7.2[2.2]；P=0.139）。从2013年起，完成12个月随访的患眼中，从雷珠单抗转换为阿柏西普的12个月转换率（19.2%）远高于从阿柏西普转换为雷珠单抗的转换率（5.4%）。未完成12个月治疗的患眼比例在雷珠单抗治疗组中为23.2%，在阿柏西普治疗组中为22.2%。
2013年至2016年期间，澳大利亚医生使用雷珠单抗和阿柏西普的比例相似。雷珠单抗在老年患者中使用更为频繁，而阿柏西普在病变较大的患眼中使用更为频繁。
