Patterns of anti-vascular endothelial growth factor treatment for chorioretinal vascular diseases: Analysis of a nationwide claims database in Japan
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Published on: January 25, 2019
Fumi Gomi1, Ryo Kawasaki2, Yuichiro Ogura3
1Department of Ophthalmology, Hyogo Medical University.
Insights
Intravitreal anti-vascular endothelial growth factor therapy for retinal diseases shows stable treatment intervals but improved continuation rates over time. This suggests better patient adherence and sustained management of these vision-threatening conditions.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacotherapy
Background:
- Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is the standard first-line treatment for chorioretinal vascular diseases in Japan.
- Limited data exists on the real-world treatment patterns of anti-VEGF therapy in this population.
Purpose of the Study:
- To investigate the treatment patterns, including intervals and continuation rates, of intravitreal anti-VEGF therapy for major chorioretinal vascular diseases in Japan.
Main Methods:
- Analysis of a Japanese health insurance claims database from acute care hospitals.
- Inclusion of patients aged ≥50 years with neovascular age-related macular degeneration (nAMD) and patients aged ≥18 years with diabetic macular edema (DME) or retinal vein occlusion (RVO).
- Estimation of treatment intervals, continuation rates, and drop-out rates using Kaplan-Meier curves.
Main Results:
- The study analyzed large cohorts: 76,535 (nAMD), 49,704 (DME), and 37,681 (RVO) patients.
- Mean treatment intervals during the maintenance phase ranged from 94-120 days and did not show significant trends over time.
- Treatment continuation rates tended to increase in later years, with notable decreases in drop-out rates in the treatment initiation year across all analyzed conditions.
Conclusions:
- Treatment intervals for intravitreal anti-VEGF therapy in nAMD, DME, and RVO remained relatively consistent.
- A trend towards improved treatment continuation was observed, indicating potentially better long-term management of these retinal vascular diseases.
Background:
Although intravitreal anti-vascular endothelial growth factor therapy is currently considered the first-line treatment for chorioretinal vascular diseases in Japan, information regarding its treatment pattern is scarce. This study investigated the patterns of anti-vascular endothelial growth factor treatment for chorioretinal vascular diseases.
Methods:
A health insurance claims database from acute care hospitals was used to estimate treatment intervals and continuation and drop-out rates regarding the anti-vascular endothelial growth factor. Patients aged ≥50 years diagnosed with neovascular age-related macular degeneration or aged ≥18 years diagnosed with diabetic macular edema or retinal vein occlusion were analyzed.
Results:
Data were included for 76,535, 49,704, and 37,681 patients with neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively; exactly 8,111, 2,283, and 6,896 received the treatment, respectively. The mean and median interval ranges during the maintenance phase by treatment initiation year were 94-100 and 73-80, 111-120 and 98-102, and 97-103 and 87-93 days for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively, without any trend over time. A tendency to increase the treatment continuation rate was indicated in later years by Kaplan-Meier curves. The drop-out rate in the treatment initiation year (2016) was 32% from 63% (2009), 53% from 69% (2014), and 36% from 47% (2013) for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusion, respectively.
Conclusions:
For all these diseases, the treatment intervals did not change remarkably, and a tendency toward improved treatment continuation was suggested.
