The Cost-Effectiveness of Ranibizumab for the Treatment of Diabetic Macular Edema

Brown, Gary C.; Brown, Melissa M.; Turpcu, Adam; Rajput, Yamina

doi:10.1016/j.ophtha.2015.03.032

Cited by 32 publications

(19 citation statements)

References 27 publications

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“…Anti-VEGF treatment improves both visual function and macular morphology in DME, whereas the severe complications and socioeconomic burden suggest the need to predict the treatment frequency on a PRN dosing schedule [8, 16–19]. In the current study, we showed for the first time that the number of IVR injections during the first year was associated positively with the retinal thickness in the inferior subfield of the ETDRS grid in eyes that received IVR injections according to the 3 + PRN regimen.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical trials have suggested that anti-VEGF therapy guarantees the best improvement in visual acuity (VA), although the socioeconomic burden persists for patients. Actually, the cost-per-quality-adjusted life years is much higher than other conventional interventions for DME [17–19]. These issues might encourage clinicians to use the PRN regimen for DME and to optimize the indications for anti-VEGF therapy using predictors of visual prognosis and treatment frequency [20].…”

Section: Introductionmentioning

confidence: 99%

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Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema

et al. 2017

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PurposeTo investigate whether baseline optical coherence tomography (OCT) parameters can predict the treatment frequency of intravitreal ranibizumab (IVR) injections during the first year in patients with diabetic macular edema (DME) treated with pro re nata (PRN) IVR injections.MethodsWe retrospectively reviewed 68 eyes of 63 patients with center-involved DME who received IVR injections for 12 months or longer according to three monthly IVR injections followed by the PRN dosing. We measured the mean retinal thicknesses in the individual subfields of the Early Treatment Diabetic Retinopathy Study grid and evaluated the qualitative and quantitative parameters on OCT sectional images. We investigated the relationship between these OCT parameters at baseline and the number of IVR injections during the 12-month follow-up.ResultsThree loading doses were administered to 10 eyes; four to seven annualized IVR injections were administered to 34 eyes. The number of eyes that received IVR injections decreased gradually until month 6 and was almost constant from months 7 to 11. No relationships were seen between the treatment frequency and baseline systemic factors and the ophthalmic examination findings. Univariate analyses showed that the number of IVR injections during the first year was associated with the mean retinal thickness in the individual subfields and the transverse length of the disrupted external limiting membrane (ELM) and ellipsoid zone of the photoreceptors. Multivariate analysis showed a significant association with the thickness in the inferior subfield alone. The treatment frequency during the 12-month follow-up was not correlated with improved visual acuity but was associated with the decrease in the central subfield thickness and disrupted ELM.ConclusionThe retinal thickness in the inferior subfield predicts the treatment frequency during the first year in eyes with DME treated with PRN IVR injections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema

et al. 2017

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“…Cost-effectiveness of various interventions for DME has been scrutinized, and lack of therapy compliance was shown to lead to a worse outcome and therefore represents a huge economic burden. [54][55][56][57] The purpose of this study is to determine patients' treatment compliance rates and investigate factors that may have a positive or negative effect on compliance with anti-VEGF treatment in a cohort of Jordanian patients with DME.…”

Section: Introductionmentioning

confidence: 99%

<p>Factors Affecting Compliance to Anti-Vascular Endothelial Growth Factor Treatment of Diabetic Macular Edema in a Cohort of Jordanian Patients</p>

Abu-Yaghi¹,

Abed²,

Khlaifat³

et al. 2020

OPTH

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Purpose: To determine compliance rates and characteristics and to investigate factors affecting patients' adherence to treatment with anti-vascular endothelial growth factors (anti-VEGFs) for diabetic macular edema (DME) in a cohort of Jordanian patients. Methods: A retrospective case series wherein the files of DME patients treated with anti-VEGFs were reviewed and analyzed for factors affecting treatment compliance was undertaken. Demographic, clinical and ocular characteristics were recorded. All patients were also interviewed by phone using a structured questionnaire. Univariate and multivariate analyses were performed to determine factors associated with compliance. Results: A total of 117 patients (65 males 52 females) were included in this study with a mean age of 62.93 years (±9.75). Approximately, 85% of patients were compliant to their treatment and follow-up plan during the first year of management. Subjective perception of visual improvement after receiving three loading doses was the only independent variable with a unique statistically significant contribution to compliance. All other studied factors in this group of patients were not significantly associated with patient compliance. Conclusion: VEGF suppression via the intravitreal route to treat DME is a long-term process that requires caregiver dedication but also proper patient compliance. Addressing real-life barriers in those patients may help guide future strategies to improve the treatment experience, lower the financial burden and contribute to better outcomes. Patients' perceptions of possible treatment outcomes at the short term may influence their long-term commitment to therapy.

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“…In addition, the increased cost because of the frequent visits with the PRN protocol can become a problem, and the fewer TAE monthly injection can reduce the cost. [20,21] …”

Section: Discussionmentioning

confidence: 99%

Two year result of intravitreal bevacizumab for diabetic macular edema using treat and extend protocol

Sugimoto

Ichio²,

Nunome³

et al. 2017

Medicine

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To determine the efficacy of the treat and extend (TAE) protocol with intravitreal bevacizumab (IVB) for managing diabetic macular edema (DME).Retrospective, single-center study.For this retrospective study, 42 eyes of 42 patients were initially treated with 3 consecutive monthly IVB injections (loading phase), after which they were selected for different additional therapies. For the TAE protocol, the baseline treatment interval was selected to be 8 weeks and was sequentially lengthened by 2 weeks if the central macular thickness (CMT) was <300 μm at 2 consecutive examinations.Among the 42 eyes, 8 eyes (19.0%) received the TAE treatment for 2 years. The BCVA was improved significantly from 0.37 ± 0.04 before treatment to 0.19 ± 0.04 logMAR units at 2 years after the TAE determined IVB injections (P < .05). The ratio of eyes with a gain of the BCVA by more than 2 lines was 37.5%. The CMT was significantly reduced from 515.4 ± 75.5 to 303.6 ± 45.0 μm after 2 years (P < .01). The mean number of TAE injection was 8.8 and the mean injection interval was 11.0 weeks.After the loading phase, 19.0% of patients can be treated with the TAE protocol. Although significant visual improvements were obtained after the TAE protocol, it does not apply to every DME case.

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The Cost-Effectiveness of Ranibizumab for the Treatment of Diabetic Macular Edema

Cited by 32 publications

References 27 publications

Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema

Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema

<p>Factors Affecting Compliance to Anti-Vascular Endothelial Growth Factor Treatment of Diabetic Macular Edema in a Cohort of Jordanian Patients</p>

Two year result of intravitreal bevacizumab for diabetic macular edema using treat and extend protocol

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