Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark.
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark.
Acta Ophthalmol. 2021 Dec;99(8):e1348-e1353. doi: 10.1111/aos.14802. Epub 2021 Feb 18.
The number of patients receiving anti-VEGF therapy has increased rapidly since its introduction in Denmark in 2007, placing an enormous pressure on the public healthcare system. In this study, we attempt to describe this growth and identify the factors driving it.
Data on treatment of the entire population of neovascular AMD patients in the Capital Region of Denmark between 2007 and 2019 was retrieved. The age and sex standardized incidences of first time treatment and changes in duration of treatment were analysed.
The number of patients in active treatment increased from 576 in 2007 to 3684 in 2019. The growth was initially driven by accumulation of patients continuing anti-VEGF therapy for extended periods of time (259 patients/year). As larger numbers of patients began to be discharged, the increase slowed to 181 patients/year in late 2010s, with demographic change becoming the main growth driving factor. The incidence of first treatment increased slightly during the study period, mainly for individuals over 85 years. For patients under 85 years, treatment incidences closely followed neovascular AMD incidences from population studies. The likelihood of remaining in anti-VEGF treatment after the initial injection followed exponential decay curve (t = 3.6 years). Based on this observation, a model was created to describe the number of patients in active treatment, which accurately described historical data (R = 0.999), and forecast a linear growth of 138 patients/year until 2030.
Treatment incidences and modelling reported in this study might facilitate a more informed and accurate planning of future ophthalmology services.
自 2007 年抗血管内皮生长因子（VEGF）疗法在丹麦推出以来，接受该疗法的患者数量迅速增加，给公共医疗系统带来了巨大压力。本研究旨在描述这种增长，并确定推动增长的因素。
检索丹麦首都大区 2007 年至 2019 年间所有新生血管性年龄相关性黄斑变性（AMD）患者的治疗数据。分析首次治疗的年龄和性别标准化发病率以及治疗持续时间的变化。
活跃治疗患者的数量从 2007 年的 576 人增加到 2019 年的 3684 人。增长最初是由持续接受抗 VEGF 治疗的患者人数不断增加（每年 259 人）推动的。随着越来越多的患者开始出院，增长率在 2010 年代末放缓至每年 181 人，人口变化成为主要的增长驱动因素。在此期间，首次治疗的发病率略有上升，主要是针对 85 岁以上的人群。对于 85 岁以下的患者，治疗发病率与人群研究中的新生血管性 AMD 发病率密切相关。初始注射后继续接受抗 VEGF 治疗的可能性遵循指数衰减曲线（t = 3.6 年）。基于这一观察结果，创建了一个模型来描述活跃治疗患者的数量，该模型准确地描述了历史数据（R = 0.999），并预测 2030 年前线性增长 138 人/年。
本研究报告的治疗发病率和模型可以为未来眼科服务的规划提供更明智和准确的依据。
