Department of Ophthalmology, Hospital Dos de Mayo, Barcelona, Spain.
Department of Ophthalmology, Hospital Universitario de Burgos, Burgos, Spain.
Eur J Ophthalmol. 2022 Jan;32(1):385-394. doi: 10.1177/11206721211001716. Epub 2021 Mar 15.
BACKGROUND/AIMS: The present study evaluates the burden of neovascular age-related macular degeneration (nAMD) to Healthcare System and patients, describing the management and treatment effectiveness in routine clinical practice in Spain.
Observational, non-interventional, cross-sectional, retrospective (24 months), multicentre study including patients who started treatment with licensed vascular endothelial growth factor inhibitors (anti-VEGF) for nAMD with a minimum follow up of 24 months.
126 evaluable patients were included with mean (SD) age of 79.1 (7.5) years. From diagnosis, it took a mean (SD) of 0.5 (0.5) months for the first treatment. Throughout 24 months, mean (SD) number of visits per patient was 16.0 (5.0), 9.4 (4.3) associated intravitreal injection. There were 1186 injection visits, 53.6% of them only with injection and 46.3% with injection and tests. After loading phase, preferred treatment regimens were T&E (46.0%), PRN (44.4%), fixed regimen (4.0%), and others (5.6%). Total number of visits in patients with T&E and PRN were 16.5 (5.7) and 15.5 (4.7), respectively. After complete loading phase, mean (SD) time between two consecutive treatment injections was 2.2 (1.6) months. 27.8% patients underwent a treatment change, being lack of response the most frequent reason to change (43.2%). Mean (SD) best-corrected visual acuity change was 2.1 (15.9) letters at 24 months.
This study showed an important burden to Healthcare System and patients related to monitoring visits. More efficacious and longer lasting treatments could be useful to increase treatment intervals, thus reducing the burden of patients and caregivers and the use of healthcare resources.
背景/目的：本研究评估了新生血管性年龄相关性黄斑变性（nAMD）给医疗保健系统和患者带来的负担，描述了西班牙常规临床实践中的治疗管理和治疗效果。
这是一项观察性、非干预性、横断面、回顾性（24 个月）多中心研究，纳入了至少接受 24 个月随访、开始使用已上市血管内皮生长因子抑制剂（抗 VEGF）治疗 nAMD 的患者。
共纳入 126 例可评估患者，平均（标准差）年龄为 79.1（7.5）岁。从诊断到首次治疗，平均（标准差）时间为 0.5（0.5）个月。在 24 个月期间，平均（标准差）每位患者的就诊次数为 16.0（5.0）次，其中 9.4（4.3）次与玻璃体腔内注射相关。共进行了 1186 次注射就诊，其中 53.6%仅进行了注射，46.3%同时进行了注射和检查。在负荷期后，首选的治疗方案为 T&E（46.0%）、PRN（44.4%）、固定方案（4.0%）和其他方案（5.6%）。T&E 和 PRN 组患者的总就诊次数分别为 16.5（5.7）次和 15.5（4.7）次。完全负荷期后，两次连续治疗注射之间的平均（标准差）时间为 2.2（1.6）个月。27.8%的患者进行了治疗方案调整，其中无应答是最常见的调整原因（43.2%）。24 个月时最佳矫正视力的平均（标准差）变化为 2.1（15.9）个字母。
本研究显示，监测就诊给医疗保健系统和患者带来了沉重负担。更有效和持久的治疗方法可能有助于延长治疗间隔，从而减轻患者和照护者的负担，减少医疗资源的使用。
