<p>Patient Preferences for Anti-Vascular Endothelial Growth Factor Treatment for Wet Age-Related Macular Degeneration in Japan: A Discrete Choice Experiment</p>

Abstract

Background: In Japan, intravitreal anti-vascular endothelial growth factor (anti-VEGF) dosing regimens for wet age-related macular degeneration (wAMD) include pro re nata, every 2 months, and treat-and-extend, resulting in different outcomes and patient burden. Although reflecting patient preferences in treatment decision-making is desirable, few studies have examined this in Japan. This study assessed the patients willingness to trade-off between different dosing regimens. Patients and Methods: Patients with wAMD were recruited from four Japanese university hospitals to complete a face-to-face cross-sectional survey. In a discrete choice experiment, patients were asked to choose their preferred option from two anti-VEGF treatment profiles shown side-by-side across a series of choice tasks. The profiles varied on four attributes: number of injections in 12 months, number of physician consultations in 12 months, chance of 1-year visual acuity (VA) improvement, and chance of 2-year VA maintenance. Preference weights were estimated using hierarchical Bayes' models. Results: Overall, 120 patients (30 treatment naïve and 90 anti-VEGF experienced) completed the survey. Patients were willing to accept an increase from three to approximately eight injections in 12 months to increase the chance of 1-year VA improvement from 25% to 40%. They would be willing to accept 11 injections in 12 months if the chance of 2-year VA maintenance increased from 80% to 96%. The most valued attributes were increasing the chance of 2-year VA maintenance and reducing the number of injections in 12 months, which were each about twice as important as decreasing physician consultations in 12 months and increasing the chance of 1-year VA improvement (p<0.001). Among the dosing regimens, patients most preferred treat-and-extend because of its higher chance of 2-year VA maintenance. Conclusion: Informing patients with wAMD about the likelihood of long-term VA maintenance when selecting treatment may increase the acceptance of an optimal treatment regimen and number of injections.

Correlation between improvement in visual acuity and QOL after Ranibizumab treatment for age-related macular degeneration patients: QUATRO study

“…They reported that patients were willing to agree to an increase in injections, from three to approximately eight, in 12 months to improve the chance of 1-year VA melioration from 25 to 40%. Between the dosing regimens, patients tended to prefer TAE due to its higher chance of 2-year VA maintenance [ 32 ]. In the future, it will be necessary to consider the treatment burden and satisfaction of patients to maintain their vision and vision-related quality of life.…”

Treatment contentment and preference of patients undergoing intravitreal anti-VEGF therapy

“…Mueller et al observed, that patients are willing to accept a high treatment burden for better functional outcome [13]. A Japanese study showed that comparing T&E, PRN and a fixed two monthly IVI regimen, the T&E dosing regimen was generally most preferred by patients [14].…”

Treatment for neovascular age-related macular degeneration: reasonable expectations of physicians and patients

“…На приверженность лечению и соблюдение его режима влияет информированность пациента. T. Joko et al [28] при помощи анкетирования оценили предпочтения пациентов при выборе того или иного режима дозирования. Большинство пациентов выбрали режим T&E, основываясь на информации о большей вероятности поддержания ОЗ в течение 2 лет.…”