Longer treatment intervals are associated with reduced treatment persistence in neovascular age related macular degeneration
© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists..
AIMS: To test the hypothesis that patients treated for neovascular age related macular degeneration (nAMD) with longer treatment intervals are more likely to persist with treatment.
METHODS: Data were obtained from the prospectively-defined Fight Retinal Blindness! registry. Treatment interval at 2 years was stratified based on the mean treatment interval over the three visits prior to and including the 2-year visit. Rates of non-persistence to follow-up were assessed from 2 to 5 years.
RESULTS: Data from 1538 eyes were included. The overall rate of non-persistence was 51% at 5 years. Patients on longer treatment intervals (12-weeks) at 2 years were found to be less persistent to long-term follow-up. These eyes were found to have fewer active disease visits in the first 2 years (40%) than eyes treated at 4-weekly intervals (66%, p < 0.001). In the multivariable analysis, better vision at 2 years was associated with a lower risk of non-persistence (hazards ratio [HR] [95% CI]: 0.95 [0.93, 0.97], P < 0.001), while longer treatment intervals (HR [95% CI]: 1.31 [0.95, 1.8] and 1.54 [1.15, 2.06] for 12-week and > 12-week intervals vs. 4-week intervals, respectively, P = 0.002) and older patients (HR [95% CI]: 1.03 [1.02, 1.04], p < 0.001) were at higher risk of non-persistence.
CONCLUSIONS: We found that patients on longer treatment intervals at 2 years were more likely to be non-persistent with treatment in later years. Reinforcing the need for ongoing treatment is important for patients on longer intervals who may feel complacent or that treatment is no longer effective, particularly if newer, longer lasting agents become widely available.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Eye (London, England) - 37(2023), 3 vom: 09. Feb., Seite 467-473 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Teo, Kelvin Y C [VerfasserIn] |
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| Links: |
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| Themen: |
Angiogenesis Inhibitors |
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| Anmerkungen: |
Date Completed 09.02.2023 Date Revised 12.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1038/s41433-022-01957-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336726007 |
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| 100 | 1 | |a Teo, Kelvin Y C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Longer treatment intervals are associated with reduced treatment persistence in neovascular age related macular degeneration |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists. | ||
| 520 | |a AIMS: To test the hypothesis that patients treated for neovascular age related macular degeneration (nAMD) with longer treatment intervals are more likely to persist with treatment | ||
| 520 | |a METHODS: Data were obtained from the prospectively-defined Fight Retinal Blindness! registry. Treatment interval at 2 years was stratified based on the mean treatment interval over the three visits prior to and including the 2-year visit. Rates of non-persistence to follow-up were assessed from 2 to 5 years | ||
| 520 | |a RESULTS: Data from 1538 eyes were included. The overall rate of non-persistence was 51% at 5 years. Patients on longer treatment intervals (12-weeks) at 2 years were found to be less persistent to long-term follow-up. These eyes were found to have fewer active disease visits in the first 2 years (40%) than eyes treated at 4-weekly intervals (66%, p < 0.001). In the multivariable analysis, better vision at 2 years was associated with a lower risk of non-persistence (hazards ratio [HR] [95% CI]: 0.95 [0.93, 0.97], P < 0.001), while longer treatment intervals (HR [95% CI]: 1.31 [0.95, 1.8] and 1.54 [1.15, 2.06] for 12-week and > 12-week intervals vs. 4-week intervals, respectively, P = 0.002) and older patients (HR [95% CI]: 1.03 [1.02, 1.04], p < 0.001) were at higher risk of non-persistence | ||
| 520 | |a CONCLUSIONS: We found that patients on longer treatment intervals at 2 years were more likely to be non-persistent with treatment in later years. Reinforcing the need for ongoing treatment is important for patients on longer intervals who may feel complacent or that treatment is no longer effective, particularly if newer, longer lasting agents become widely available | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Angiogenesis Inhibitors |2 NLM | |
| 650 | 7 | |a Vascular Endothelial Growth Factor A |2 NLM | |
| 650 | 7 | |a Ranibizumab |2 NLM | |
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| 700 | 1 | |a Nguyen, Vuong |e verfasserin |4 aut | |
| 700 | 1 | |a O'Toole, Louise |e verfasserin |4 aut | |
| 700 | 1 | |a Daien, Vincent |e verfasserin |4 aut | |
| 700 | 1 | |a Sanchez-Monroy, Jorge |e verfasserin |4 aut | |
| 700 | 1 | |a Ricci, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Ponsioen, Theodorus Leonardus |e verfasserin |4 aut | |
| 700 | 1 | |a Morros, Helena Brosa |e verfasserin |4 aut | |
| 700 | 1 | |a Cheung, Chui Ming Gemmy |e verfasserin |4 aut | |
| 700 | 1 | |a Arnold, Jennifer J |e verfasserin |4 aut | |
| 700 | 1 | |a Barthelmes, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Gillies, Mark C |e verfasserin |4 aut | |
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