Patient preference of ranibizumab treatment regimen for neovascular age-related macular degeneration — monthly injections versus pro re nata

Droege, Katharina M.; Caramoy, Albert; Kersten, Andreas; Luberichs-Fauser, Janina; Zilkens, Katharina; Müller, Dirk; Kirchhof, Bernd; Fauser, Sascha

doi:10.1007/s00417-013-2412-6

Cited by 27 publications

(34 citation statements)

References 5 publications

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“…Concurring with reported high levels of treatment compliance 23 participants of this study continued with the treatment even when experiences of pain or discomfort were reported, illuminating a deep association between compliance and fear of blindness. 16,26 A fear of blindness Living with neovascular ARMD: the patient's story C McCloud and S Lake was pervasive in this study population, and more than one participant felt that death would be preferable to living with the limitations of blindness, which was a finding that resonated with suicide ideation following vision loss described by Casten and Rovner in 2008.…”

Section: Discussionmentioning

confidence: 66%

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Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

McCloud

Lake

2015

Eye

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Purpose In industrialised populations agerelated macular degeneration (ARMD) is the leading cause of visual disability of the elderly. Successful new treatment with anti-endothelial growth factors for neovascular-classified ARMD has led to a divergence in treatment and experiences of people ARMD. This study aimed to understand the participant's experience of neovascular ARMD, including ongoing treatment with anti-vascular endothelial growth factor. Methods Twenty-five participants from one clinical site were qualitatively interviewed to elicit their experiences of treatment for neovascular ARMD. Results Two major themes were identified. A life negotiated by neovascular ARMD captures the participants' experience of living with the condition and treatment regime for neovascular ARMD. The second major theme: Uncertainty displayed their appraisal of life, treatment and their perceived future. Conclusions Anxieties concerning the injections, new limitations to lifestyles, and an uncertain future all emerged from the data analysis. However, thankfulness for the treatment, the importance of familiar patterns in treatments and recovery and a guarded optimism also emerged. Knowledge of the experiences, anxieties and concerns of this patient population can be used to inform clinical practice and lead to patient-centred care.

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Section: Discussionmentioning

confidence: 66%

“…23,24 Analysis commenced after the first five interviews and was consistent with constant comparison technique where new data was examined in light of the emerging themes. The use of constant comparison techniques enhanced the 'fit' between data and developing themes and added to the trustworthiness of the findings.…”

Section: Thematic Analysismentioning

confidence: 99%

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

McCloud

Lake

2015

Eye

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“…This is consistent with the findings of a questionnaire survey performed on patients in Cologne, Germany where patients again expressed preference for bi-monthly rather than monthly visits. 17 Patients also expressed a preference for shorter waiting times, as a survey of Spanish patients also found, 18 but this was less important than attending once every 8 weeks. Preference for doctor injectors was low and this broadly supports the use of training nurses to perform intravitreal injections.…”

Section: Discussionmentioning

confidence: 99%

Determining patient preferences in the management of neovascular age-related macular degeneration: a conjoint analysis

Baxter

Fotheringham

Foss

2016

Eye

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Purpose To determine the opinions from a patient perspective on relevant variables in the delivery of treatment for neovascular age-related macular degeneration (nAMD). Methods Pilot interviews with patients and doctors were conducted to identify what variables in the provision of a nAMD service were important. This led to the generation of two sets of scenario options. Subsequently 100 patients undergoing active treatment for nAMD in the National Health Service University Hospital, United Kingdom underwent interview assessment. They were asked to rank their preferences for provision of their care with reference to these two sets of scenario options. Using conjoint analysis, percentage preferences, and utility scores for each variable in each scenario design were calculated. Results Ninety-five patients completed the preference ranking for both scenarios. Eight patients ranked worse vision as preferable to better vision and were excluded on the basis that they had not understood the task. The results of the remaining 87 patients are presented. The most important factor to patients was having good vision, followed by a one-stop service and less frequent follow up. The least important factors were label status of the drug, cost to the health service, and grade of the injector. Conclusion Patients regard good vision and minimal visits to the hospital above the status of injector, label status of drug, or cost to the NHS.

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“…For ranibizumab, one trial showed that only 6% of subjects typically require monthly dosing, while the remainder can be treated less frequently using an individualized approach [10] . Thus, real-life treatment of nAMD is typically individualized for most subjects following initial monthly treatment [11][12][13] , with clear benefits seen with early treatment [14] . Indeed, individualized dosing is recommended in the prescribing information for ranibizumab and the intervals between doses can be extended according to the treating physician's opinion and an assessment of disease severity [11] .…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Predictors of Early and Delayed Responders to Ranibizumab Treatment in Neovascular Age-Related Macular Degeneration: A Retrospective Analysis from the ANCHOR, MARINA, HARBOR, and CATT Trials

et al. 2016

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Purpose: This retrospective review examined visual acuity (VA) in subjects with neovascular age-related macular degeneration and identified early and delayed response to ranibizumab. Procedures: MARINA, ANCHOR, HARBOR, and CATT published data were examined for response with monthly versus individualized dosing and predictors of early versus delayed response. Results: Data were available for 1,631 subjects; 18-29% were early gainers and 15-16% were delayed gainers. Of the early gainers, 72-83% maintained their best-corrected VA gain at month 12 with monthly or individualized dosing. Delayed gainers in HARBOR almost reached the same level of response as early gainers by 12 months who were able to maintain their response. The main predictor of response was baseline VA. Conclusion: There are two distinct types of ranibizumab response; some responded by month 3, while others took up to 12 months. In delayed responders, this may have implications for switching or not switching therapies.

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Patient preference of ranibizumab treatment regimen for neovascular age-related macular degeneration — monthly injections versus pro re nata

Cited by 27 publications

References 5 publications

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

Determining patient preferences in the management of neovascular age-related macular degeneration: a conjoint analysis

Characteristics and Predictors of Early and Delayed Responders to Ranibizumab Treatment in Neovascular Age-Related Macular Degeneration: A Retrospective Analysis from the ANCHOR, MARINA, HARBOR, and CATT Trials

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