Predictors of visual outcomes in patients with neovascular age‐related macular degeneration treated with anti‐vascular endothelial growth factor therapy: <i>post hoc</i> analysis of the <scp>VIEW</scp> studies

Lanzetta, Paolo; Cruess, Alan F.; Cohen, Salomon Y.; Slakter, Jason S.; Katz, Todd A; Sowade, Olaf; Zeitz, Oliver; Ahlers, Christiane; Mitchell, Paul

doi:10.1111/aos.13751

Cited by 28 publications

(24 citation statements)

References 14 publications

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“…Younger age as a prediction factor for better response to ranibizumab treatment is in-line with the Korean PMS study (10) and several post hoc analyses of pivotal trials and studies assessing predictors of response to ranibizumab (30)(31)(32)(33)(34)(35). Findings from the current study also strengthen the observation regarding baseline VA being an important factor in predicting visual outcome, consistent with the Korean PMS study, (10) the study by Pedrosa et al (2016) (36), the LUMIERE study (20), and the global LUMINOUS study (11,22).…”

Section: Discussionsupporting

confidence: 72%

Real-world effectiveness, treatment pattern, and safety of ranibizumab in Korean patients with neovascular age-related macular degeneration: Subgroup analyses from the LUMINOUS study

Sagong

Woo

Lee

2020

Preprint

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Background To evaluate the real-world effectiveness, treatment patterns, and safety of ranibizumab in Korean patients with neovascular age-related macular degeneration (nAMD). Methods LUMINOUS™ is a 5-year, global, prospective, observational, open-label study. Adults aged ≥18 years who were either treatment-naïve or prior-treated were enrolled and treated with ranibizumab 0.5 mg per the local label. Outcome measures included mean (±standard deviation) changes from baseline in visual acuity (VA) and central retinal thickness (CRT), and rate of ocular and non-ocular adverse events (AEs). Results Overall, 367 Korean patients with nAMD (152 treatment-naïve and 215 prior-treated) were enrolled. The mean VA changes from baseline at 1-year were +10.1 (±21.77; P = 0.0005) and +1.4 (±15.17; P = 0.2142) Early Treatment Diabetic Retinopathy Study letters, with mean number of injections of 5.2 and 3.4 in the treatment-naïve and prior-treated groups, respectively. VA gains were greater in patients with worse baseline VA, who received a loading dose, and with polypoidal choroidal vasculopathy (PCV). Multivariate logistic regression analyses demonstrated younger age, worse baseline VA, and those who received loading dose being associated with higher odds of any gain in VA at 1 year ( P < 0.05). Mean CRT changes from baseline were –126.7 (±174.90) µm ( P < 0.0001) and +10.8 (±89.52) µm ( P = 0.5833) in the treatment-naïve and prior-treated groups, respectively, with greater reductions observed in patients with PCV. Ocular and non-ocular AEs were reported in 8.4% (n=31) and 10.1% (n=37) of patients, respectively. Conclusion The LUMINOUS study confirms real-world effectiveness and safety of ranibizumab in Korean patients with nAMD; factors including age, baseline VA, and loading-dose were associated with VA gain at one-year post-treatment.

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Section: Discussionsupporting

confidence: 72%

Real-world effectiveness, treatment pattern, and safety of ranibizumab in Korean patients with neovascular age-related macular degeneration: Subgroup analyses from the LUMINOUS study

Sagong

Woo

Lee

2020

Preprint

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“…For a good visual outcome, however, baseline VA seems to be the most important factor and more important than the frequency of injections, something that was also found in a post hoc analysis of the View studies (Lanzetta et al. ). As expected we also found that a better baseline VA was associated with shorter symptom duration, something that investigated in a study in Denmark, which found that shorter symptom duration was beneficial for a better visual outcome (Rasmussen et al.…”

Section: Discussionmentioning

confidence: 61%

Baseline visual acuity as a prognostic factor for visual outcomes in patients treated with aflibercept for wet age‐related macular degeneration: data from the INSIGHT study using the Swedish Macula Register

Adrian

Vassilev

Westborg

2018

Acta Ophthalmologica

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Purpose: To assess mean change in visual acuity (VA) overall and stratified by baseline VA after 1 and 2 years' treatment with aflibercept in a real-life setting. Methods: This was an observational cohort study using nationwide data from the Swedish Macula Register. Treatment-na€ ıve patient eyes with wet age-related macular degeneration and prescribed aflibercept from January 2013 to December 2014 were followed for 1 year (2478 eyes) or 2 years (831 eyes) to assess VA. Eyes were grouped by baseline VA. Results: Mean number of injections in patients treated according to label (72%) versus patients treated not according to label was 8.0 AE 1.5 versus 4.4 AE 0.8 (p < 0.0001) at 1 year, and 12.5 AE 3.2 versus 7.3 AE 1.9 (p < 0.0001) at 2 years. Among all eyes, mean VA increased from 61.3 AE 13.4 Early Treatment Diabetic Retinopathy Study letters at baseline to 64.5 AE 15.6 at 1 year and 65.1 AE 15.1 letters at 2 years. At 2 years, eyes with good baseline vision (≥70 letters) lost a mean of 2.4 AE 11.3 to 72.3 letters, eyes with intermediate baseline VA (36-69 letters) gained 5.7 AE 14.1 to 62.7 letters, and eyes with poor baseline VA (≤35 letters) gained 13.2 AE 18.3 to 41.0 letters. Also at 2 years, 75% of treated eyes were stable or had improved VA. Among eyes with intermediate baseline VA, near vision was significantly better among those treated according to label versus not according to label at 3 (p = 0.019), 6 (p = 0.0002) and 12 months (p ≤ 0.0001). Conclusion: While gain in vision was especially pronounced in eyes with poor baseline VA, good baseline VA was important for best prognosis.

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“…5.0 letters from a mean baseline of 56.3 letters [12]. It is known that older age, better baseline BCVA and larger choroidal neovascularization lesion size are independently associated with lower mean BCVA gains after anti-VEGF therapy [20,21]. However, aside from baseline visual acuity, no other baseline disease characteristics or patient demographics were collected in STELLAR.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Aflibercept Treatment Strategies in Routine Clinical Practice of Neovascular Age-Related Macular Degeneration in Belgium: A Retrospective Observational Study

et al. 2020

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Introduction: STELLAR was a Belgian, multicentre, retrospective, observational chart review that described the utilization (number of injections and treatment regimen) and effectiveness of intravitreal aflibercept (IVT-AFL) in patients with anti-vascular endothelial growth factor (VEGF) treatment-naïve neovascular age-related macular degeneration (nAMD) during the first 12 months of IVT-AFL treatment. Methods: Patients initiating IVT-AFL between July 2013 and July 2017 were included in STELLAR. Primary endpoints were number of visits and IVT-AFL injections, and number of patients who received C 7 versus \ 7 IVT-AFL injections during the first 12 months of treatment. Results: A total of 337 patients completed C 12 months of IVT-AFL treatment. The mean number of visits and mean number of injections during the first 12 months was 9.8 and 7.1 injections, respectively (64% received C 7 injections). Overall, 96% of patients received C 3 initial monthly injections. Of the 337 patients, 180 received VT-AFL as needed (pro re nata), 141 received it as treatand-extend dosing and 16 received it as fixed dosing. The proportion of patients who received treatand-extend dosing increased year-on-year. Mean best-corrected visual acuity (BCVA) (± standard deviation) was 61.6 (± 14.9) Early Treatment Diabetic Retinopathy Study (ETDRS) letters at baseline and improved by ? 3.9 and ? 5.7 ETDRS letters at 3 and 12 months, respectively. Mean BCVA improvement was numerically greater in patients who received C 7 versus\7 injections during the first 12 months 7 (? 6.5 vs. ? 4.4 ETDRS letters) and in patients who received C 3 versus \ 3 initial monthly injections (? 5.2 vs.-0.25 ETDRS letters [3 at months]; ? 5.9 vs ? 1.2 ETDRS letters [at 12 months]). No specific adverse events were reported.

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Predictors of visual outcomes in patients with neovascular age‐related macular degeneration treated with anti‐vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies

Cited by 28 publications

References 14 publications

Real-world effectiveness, treatment pattern, and safety of ranibizumab in Korean patients with neovascular age-related macular degeneration: Subgroup analyses from the LUMINOUS study

Real-world effectiveness, treatment pattern, and safety of ranibizumab in Korean patients with neovascular age-related macular degeneration: Subgroup analyses from the LUMINOUS study

Baseline visual acuity as a prognostic factor for visual outcomes in patients treated with aflibercept for wet age‐related macular degeneration: data from the INSIGHT study using the Swedish Macula Register

Intravitreal Aflibercept Treatment Strategies in Routine Clinical Practice of Neovascular Age-Related Macular Degeneration in Belgium: A Retrospective Observational Study

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