Katja Hatz1, Christian Prünte1. 1. Vista Klinik, Binningen, Switzerland Department of Ophthalmology, Kantonsspital Liestal, Liestal, Switzerland University of Basel, Basel, Switzerland.
Abstract
BACKGROUND: Treat and extend (TE) treatment regimens have the potential to reduce the treatment burden placed upon patients receiving ranibizumab for neovascular age-related macular degeneration (nAMD). This study aimed to analyse changes in best corrected visual acuity (BCVA) and anatomical parameters in patients switching from a pro re nata (PRN) to a TE regimen during routine clinical practice. METHODS: Retrospective, consecutive, comparative case series of treatment-naïve patients who were initially treated with 0.5 mg ranibizumab according to a PRN schedule, and subsequently switched to a TE schedule (12-month follow-up). RESULTS: 146 eyes from 134 consecutive treatment-naïve patients were included. Mean BCVA (decimal±SD) increased from 0.39±0.23 to 0.55±0.22 (p<0.001) during the PRN loading regimen, declining to 0.49±0.22 (p<0.001) during the PRN maintenance phase (mean duration 17 months; range 3-55). Following the switch to TE, BCVA improved to 0.55±0.23 and 0.56±0.24 by 6 and 12 months, respectively (p<0.001). Mean intraindividual variance in BCVA was higher during the PRN phase than at 12 months for TE (0.30±0.18 vs 0.09±0.08, respectively; p<0.001). After switching to TE, mean central retinal thickness decreased from 355±112 µm to 330±105 and 320±103 µm at 6 and 12 months, respectively (p<0.001). Mean number of visits per month was higher during PRN than TE periods (1.05±0.13 vs 0.73±0.18; respectively; p<0.001). CONCLUSIONS: A TE regimen can improve and stabilise patient outcomes in nAMD compared with PRN, with the potential to reduce the healthcare resource burden incurred from fixed monitoring requirements. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: Treat and extend (TE) treatment regimens have the potential to reduce the treatment burden placed upon patients receiving ranibizumab for neovascular age-related macular degeneration (nAMD). This study aimed to analyse changes in best corrected visual acuity (BCVA) and anatomical parameters in patients switching from a pro re nata (PRN) to a TE regimen during routine clinical practice. METHODS: Retrospective, consecutive, comparative case series of treatment-naïve patients who were initially treated with 0.5 mg ranibizumab according to a PRN schedule, and subsequently switched to a TE schedule (12-month follow-up). RESULTS: 146 eyes from 134 consecutive treatment-naïve patients were included. Mean BCVA (decimal±SD) increased from 0.39±0.23 to 0.55±0.22 (p<0.001) during the PRN loading regimen, declining to 0.49±0.22 (p<0.001) during the PRN maintenance phase (mean duration 17 months; range 3-55). Following the switch to TE, BCVA improved to 0.55±0.23 and 0.56±0.24 by 6 and 12 months, respectively (p<0.001). Mean intraindividual variance in BCVA was higher during the PRN phase than at 12 months for TE (0.30±0.18 vs 0.09±0.08, respectively; p<0.001). After switching to TE, mean central retinal thickness decreased from 355±112 µm to 330±105 and 320±103 µm at 6 and 12 months, respectively (p<0.001). Mean number of visits per month was higher during PRN than TE periods (1.05±0.13 vs 0.73±0.18; respectively; p<0.001). CONCLUSIONS: A TE regimen can improve and stabilise patient outcomes in nAMD compared with PRN, with the potential to reduce the healthcare resource burden incurred from fixed monitoring requirements. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Helena Giannakaki-Zimmermann; Alexandra Behrndt; Laura Hoffmann; Maria-Magdalena Guichard; Cengiz Türksever; Christian Prünte; Katja Hatz Journal: Ophthalmic Res Date: 2021-01-26 Impact factor: 2.892
Authors: Robert L Johnston; Hans-Joachim Carius; Adrian Skelly; Alberto Ferreira; Fran Milnes; Paul Mitchell Journal: Adv Ther Date: 2017-01-31 Impact factor: 3.845
Authors: Rebecca N Evans; Barnaby C Reeves; Maureen G Maguire; Daniel F Martin; Alyson Muldrew; Tunde Peto; Chris Rogers; Usha Chakravarthy Journal: JAMA Ophthalmol Date: 2020-10-01 Impact factor: 7.389