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Clinical utilization of anti-vascular endothelial growth-factor agents and patient monitoring in retinal vein occlusion and diabetic macular edema

Clinical ophthalmology (Auckland, N.Z.), 2014-01, Vol.8 (default), p.1611-1621 [Peer Reviewed Journal]

COPYRIGHT 2014 Dove Medical Press Limited ;COPYRIGHT 2014 Dove Medical Press Limited ;2014. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2014 Kiss et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License 2014 ;ISSN: 1177-5467 ;ISSN: 1177-5483 ;EISSN: 1177-5483 ;DOI: 10.2147/opth.s60893 ;PMID: 25210429

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  • Title:
    Clinical utilization of anti-vascular endothelial growth-factor agents and patient monitoring in retinal vein occlusion and diabetic macular edema
  • Author: Kiss, Szilárd ; Liu, Ying ; Brown, Joseph ; Holekamp, Nancy M ; Almony, Arghavan ; Campbell, Joanna ; Kowalski, Jonathan W
  • Subjects: Age ; Clinical medicine ; Control ; Diabetes ; Diabetic retinopathy ; Diagnosis ; Drug therapy ; Edema ; Eye diseases ; FDA approval ; Health maintenance organizations ; HMOs ; Immunotherapy ; Lasers ; Macular degeneration ; Medicare ; Monitoring ; Monoclonal antibodies ; Occlusion ; Ophthalmology ; Optical Coherence Tomography ; Original Research ; Patients ; Studies ; Trends ; Utilization ; Vascular endothelial growth factor ; Veins
  • Is Part Of: Clinical ophthalmology (Auckland, N.Z.), 2014-01, Vol.8 (default), p.1611-1621
  • Description: To examine the utilization of bevacizumab and ranibizumab and disease monitoring in patients with branch or central retinal vein occlusion (BRVO/CRVO) or diabetic macular edema (DME) in clinical practice. This retrospective claims analysis included newly diagnosed patients with one or more bevacizumab or ranibizumab injections. Bevacizumab or ranibizumab utilization was assessed by year of first injection: 2008-2010 cohorts (12-month follow-up), January to June 2011 cohort (6-month follow-up). The main outcome measures were mean annual numbers of injections, ophthalmologist visits and optical coherence tomography examinations, and proportion of patients with additional laser or intravitreal triamcinolone (IVTA) use. A total of 885 BRVO, 611 CRVO, and 2,733 DME patients treated with bevacizumab were included, with too few ranibizumab-treated patients for meaningful analysis. Across the 2008, 2009, and 2010 cohorts, mean annual numbers of bevacizumab injections increased, but remained low (BRVO 2.5, 3.1, 3.3; CRVO 3.1, 3.1, 3.5; and DME 2.2, 2.5, 3.6, respectively); mean ophthalmologist visits ranged between 4.4 and 6.5, and mean optical coherence tomography examinations ranged between 3.1 and 3.9 across all conditions. A total of 42.0% of BRVO, 16.5% of CRVO, and 57.7% of DME patients received additional laser or IVTA therapy. The number of bevacizumab injections was positively associated with laser use in BRVO (3.3 versus 2.9, P<0.03), and with laser or IVTA use in DME (laser, 3.3 versus 2.7, P<0.03; IVTA, 3.3 versus 3.0, P<0.05). During the study period (2008-2011), bevacizumab was the main anti-VEGF therapy used in clinical practice for BRVO, CRVO, and DME. Patients treated with bevacizumab were monitored less frequently and received fewer injections than patients in major clinical trials of ranibizumab.
  • Publisher: New Zealand: Dove Medical Press Limited
  • Language: English
  • Identifier: ISSN: 1177-5467
    ISSN: 1177-5483
    EISSN: 1177-5483
    DOI: 10.2147/opth.s60893
    PMID: 25210429
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    PubMed Central
    ProQuest Central
    DOAJ Directory of Open Access Journals
    Dove Press Free
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