早期转换为阿柏西普治疗持续性糖尿病黄斑水肿可带来更好的视力预后和更低的治疗成本。

Early Conversion to Aflibercept for Persistent Diabetic Macular Edema Results in Better Visual Outcomes and Lower Treatment Costs.

作者信息

Ramsey David J, Poulin Samuel J, LaMonica Lauren C, Blaha Gregory R, Barouch Fina C, Chang Jeffrey, Marx Jeffrey L

机构信息

Division of Ophthalmology, Lahey Hospital & Medical Center, Tufts University School of Medicine, Peabody, MA 01960, USA.

University of Michigan Medical School, Ann Arbor, MI 48109, USA.

出版信息

Clin Ophthalmol. 2021 Jan 8;15:31-39. doi: 10.2147/OPTH.S286665. eCollection 2021.

DOI:10.2147/OPTH.S286665

PMID:33447009

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7802895/

Abstract

PURPOSE

To evaluate the functional and anatomic outcomes, as well as cost-effectiveness, of the timing of conversion to intravitreal aflibercept (IVA) in patients with treatment-resistant diabetic macular edema (DME).

METHODS

Thirty consecutive eyes (25 patients) were identified that were treated with ≥3 intravitreal bevacizumab (IVB) and/or ranibizumab (IVR) injections prior to treatment with ≥3 IVA injections. Eyes that received ≤6 IVB and/or IVR injections (early-switch) were compared to those that received ≥7 injections (late-switch) prior to conversion to IVA. Treatment effectiveness was measured in quality-adjusted life years (QALYs). A micro-simulation model examined the impact of treatment duration on outcomes.

RESULTS

Early- (n=18) and late- (n=12) switch eyes had similar vision prior to conversion to IVA. Despite improvements in retinal thickness, only the early-switch eyes maintained vision gains after conversion to IVA through the end of follow-up (=0.027). Early switch saved $22,884/eye and produced an additional 0.027 QALYs.

CONCLUSION

Early conversion to IVA optimizes vision outcomes and results in lower overall treatment expenditures.

摘要

目的

评估治疗抵抗性糖尿病性黄斑水肿（DME）患者转换为玻璃体内注射阿柏西普（IVA）的时机对功能和解剖学结果以及成本效益的影响。

方法

确定连续30只眼（25例患者），这些眼在接受≥3次玻璃体内注射阿柏西普（IVA）治疗之前接受了≥3次玻璃体内注射贝伐单抗（IVB）和/或雷珠单抗（IVR）。将接受≤6次IVB和/或IVR注射（早期转换）的眼与在转换为IVA之前接受≥7次注射（晚期转换）的眼进行比较。治疗效果以质量调整生命年（QALY）衡量。一个微观模拟模型研究了治疗持续时间对结果的影响。