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美国临床实践中接受玻璃体内抗血管内皮生长因子治疗糖尿病性黄斑水肿患者的评估

Evaluation of Patients Receiving Intravitreal Antivascular Endothelial Growth Factor for Diabetic Macular Edema in Clinical Practice in the United States.

作者信息

Pitcher John D, Moshfeghi Andrew A, Lucas Genevieve, Boucher Nick, Moini Hadi, Saroj Namrata

机构信息

Eye Associates of New Mexico, Albuquerque, NM, USA.

Department of Ophthalmology, University of New Mexico, Albuquerque, NM, USA.

出版信息

J Vitreoretin Dis. 2020 Sep 30;5(2):108-113. doi: 10.1177/2474126420953067. eCollection 2021 Mar-Apr.

Abstract

PURPOSE

We assessed the effect of treatment frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents on visual acuity (VA) in diabetic macular edema (DME).

METHODS

This retrospective analysis assessed electronic medical records of eyes newly diagnosed with DME and treated with an anti-VEGF agent at US clinics using the Vestrum Health (Naperville, Illinois) treatment and outcomes database. Eyes were divided into 2 injection frequency subcohorts (≤ 6 vs > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated.

RESULTS

Among 155 240 eyes assessed, 3028 met inclusion criteria for analysis in year 1 and 1292 in year 2. During year 1 of treatment, 57% (n = 1725) received > 6 injections; most continued to receive the same injection frequency during year 2. Mean VA gain from baseline at year 1 was lower in the ≤ 6 than in the > 6 injections/year subcohort (3.7 vs 8.0 letters, respectively; < .001). Mean VA change from the end of year 1 to year 2 for eyes receiving ≤ 6 injections in year 1 generally remained unchanged, irrespective of year 2 dosing frequency. In eyes that received > 6 injections in year 1, mean VA loss was significantly greater for eyes receiving less-frequent dosing in year 2 than in those maintained on > 6 injections.

CONCLUSIONS

More than 50% of eyes with DME in routine clinical practice that completed at least 1 year of follow-up received > 6 injections of an anti-VEGF agent during the first year, resulting in better VA gains than eyes treated less frequently.

摘要

目的

我们评估了玻璃体内抗血管内皮生长因子(抗VEGF)药物的治疗频率对糖尿病性黄斑水肿(DME)患者视力(VA)的影响。

方法

这项回顾性分析使用Vestrum Health(伊利诺伊州内珀维尔)治疗和结果数据库,评估了美国诊所中初诊为DME并接受抗VEGF药物治疗的眼部电子病历。将眼睛分为2个注射频率亚组(≤6次注射/年与>6次注射/年);评估治疗频率和平均视力(早期治疗糖尿病性视网膜病变研究字母数)的变化。

结果

在评估的155240只眼中,3028只在第1年符合纳入分析标准,1292只在第2年符合标准。在治疗的第1年,57%(n = 1725)接受了>6次注射;大多数在第2年继续保持相同的注射频率。在≤6次注射/年亚组中,第1年从基线开始的平均视力提高低于>6次注射/年亚组(分别为3.7和8.0个字母;P <.001)。在第1年接受≤6次注射的眼睛中,从第1年末到第2年的平均视力变化总体保持不变,与第2年的给药频率无关。在第1年接受>6次注射的眼睛中,第2年接受较低频率给药的眼睛的平均视力损失明显大于维持>6次注射的眼睛。

结论

在常规临床实践中,完成至少1年随访的DME患者中,超过50%在第1年接受了>6次抗VEGF药物注射,与注射频率较低的眼睛相比,视力提高更好。

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本文引用的文献

1
Visual Acuity Outcomes in Patients Receiving Frequent Treatment of Neovascular Age-Related Macular Degeneration in Clinical Practice.
J Vitreoretin Dis. 2020 Oct 27;5(3):221-226. doi: 10.1177/2474126420960896. eCollection 2021 May-Jun.
2
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Br J Ophthalmol. 2021 Feb;105(2):216-221. doi: 10.1136/bjophthalmol-2020-315933. Epub 2020 Apr 7.
3
Real-world Outcomes of Anti-Vascular Endothelial Growth Factor Therapy in Diabetic Macular Edema in the United States.
Ophthalmol Retina. 2018 Dec;2(12):1179-1187. doi: 10.1016/j.oret.2018.06.004. Epub 2018 Jul 29.
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Treatment Efficacy and Compliance in Patients with Diabetic Macular Edema Treated with Ranibizumab in a Real-Life Setting.
J Ophthalmol. 2018 Apr 18;2018:4610129. doi: 10.1155/2018/4610129. eCollection 2018.
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Clin Ophthalmol. 2017 Feb 21;11:393-401. doi: 10.2147/OPTH.S128509. eCollection 2017.
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