Real-world vision in age-related macular degeneration patients treated with single anti–VEGF drug type for 1 year in the IRIS registry
P Rao, F Lum, K Wood, C Salman, B Burugapalli… - Ophthalmology, 2018 - Elsevier
Ophthalmology, 2018•Elsevier
Purpose The purpose of this study is to compare real-world visual acuity (VA) in patients with
neovascular age-related macular degeneration (nAMD) treated with a single anti–vascular
endothelial growth factor (VEGF) drug monotherapy for 1 year from the American Academy
of Ophthalmology (AAO) Intelligent Research in Sight (IRIS) Registry. Design Retrospective,
nonrandomized, comparative study. Participants IRIS Registry patients with nAMD who
received bevacizumab, ranibizumab, or aflibercept only for 1 year between 2013–2016 …
neovascular age-related macular degeneration (nAMD) treated with a single anti–vascular
endothelial growth factor (VEGF) drug monotherapy for 1 year from the American Academy
of Ophthalmology (AAO) Intelligent Research in Sight (IRIS) Registry. Design Retrospective,
nonrandomized, comparative study. Participants IRIS Registry patients with nAMD who
received bevacizumab, ranibizumab, or aflibercept only for 1 year between 2013–2016 …
Purpose
The purpose of this study is to compare real-world visual acuity (VA) in patients with neovascular age-related macular degeneration (nAMD) treated with a single anti–vascular endothelial growth factor (VEGF) drug monotherapy for 1 year from the American Academy of Ophthalmology (AAO) Intelligent Research in Sight (IRIS) Registry.
Design
Retrospective, nonrandomized, comparative study.
Participants
IRIS Registry patients with nAMD who received bevacizumab, ranibizumab, or aflibercept only for 1 year between 2013–2016.
Methods
Participants were divided into 3 groups based on monotherapy type. Multivariate analysis of covariance models (ANCOVA) was constructed in a stepwise fashion.
Main Outcome Measures
The logarithm of the minimum angle of resolution (logMAR) VA at 1 year and mean change in logMAR VA between baseline and 1 year were compared between drug types.
Results
Of 13 859 patients, 6723 received bevacizumab, 2749 received ranibizumab, and 4387 received aflibercept only for 1 year. A total of 84 828 injections were performed. The mean number of injections (standard deviation) at 1 year was higher in the ranibizumab (6.4 [±2.4]) and aflibercept groups (6.2 [±2.4]) compared to bevacizumab group (5.9 [±2.4]; P < 0.0001). In the age-adjusted model, both ranibizumab and aflibercept achieved better logMAR VA at 1 year compared with bevacizumab (0.50 [±0.49], 0.49 [±0.44], 0.55 [±0.57]; P < 0.0001). However, this difference was not significant after multivariate adjustment (age, baseline VA, diabetes, posterior vitreous detachment, number of injections, race, insurance). There was no statistical difference in the age-adjusted or multivariate-adjusted mean logMAR VA change (standard deviation) at 1 year among treatment groups (−0.048 [0.44] bevacizumab, −0.053 [0.46] ranibizumab, −0.040 [0.39] aflibercept; P = 0.46). A higher percentage of patients achieved a ≥3-line VA improvement at 1 year in the bevacizumab group (22.7%) compared with ranibizumab (20.1%; P = 0.0093) and aflibercept (17.8%; P < 0.0001). However, after multivariate adjustment, aflibercept exhibited a greater log odds of a ≥3-line VA loss compared with bevacizumab only (1.25 log odds ratio; P < 0.0016).
Conclusions
This study suggests that all 3 drugs improve VA similarly over 1 year of monotherapy.
Elsevier
