Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study
Abstract Background This study aimed to analyse the persistence rates of treatment-naïve patients with neovascular age-related macular degeneration (nAMD) who received intravitreal aflibercept therapy in a universal health care system. Methods In this single-centre retrospective cohort study, we au...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-022-02593-7 |
| _version_ | 1798001665369964544 |
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| author | Reinhard Angermann Alexander Franchi Katharina Frede Victoria Stöckl Christoph Palme Martina Kralinger Claus Zehetner |
| author_facet | Reinhard Angermann Alexander Franchi Katharina Frede Victoria Stöckl Christoph Palme Martina Kralinger Claus Zehetner |
| author_sort | Reinhard Angermann |
| collection | DOAJ |
| description | Abstract Background This study aimed to analyse the persistence rates of treatment-naïve patients with neovascular age-related macular degeneration (nAMD) who received intravitreal aflibercept therapy in a universal health care system. Methods In this single-centre retrospective cohort study, we audited data of 918 treatment-naïve patients who received exclusively intravitreal aflibercept therapy for nAMD between September 2015 and May 2021. The primary outcome measures were the rates of treatment nonpersistence (gap in ophthalmological care > 6 months) and long-term nonpersistence (> 12 months). Results The rates of nonpersistence and long-term nonpersistence were 12.3% and 3.4% after one year; 22.4% and 9.5% after two years; and 38.3% and 19.3% after five years, respectively. Logistic regression analysis revealed that older age (p = 0.045), male sex (p = 0.039), requirement for caretakers or ambulance (p = 0.001), and low visual acuity of the study eye (p = 0.010) or fellow eye (p = 0.029) were independent risk factors for long-term nonpersistence. Patients aged > 80 and > 85 years (p = 0.013 and p = 0.022, respectively) had more than twice the risk for being nonpersistent to therapy within two years of follow-up compared with younger patients. Male patients (p = 0.033), patients requiring a caretaker (p = 0.038), and patients living > 60 km from the clinic (p = 0.029) had a 2 × higher risk of being persistently nonpersistent to therapy. Conclusions Patients with nAMD who were treated with aflibercept had lower nonpersistence rates than those reported in current literature. Multiple independent risk factors were correlated with long-term nonpersistence, early nonpersistence, or complete loss to follow-up. Considering the possible consequences of reduced compliance, further strategies are urgently needed for patients at risk of nonpersistence to therapy. |
| first_indexed | 2024-04-11T11:39:55Z |
| format | Article |
| id | doaj.art-4637e97c40aa4c30b669844b525a6282 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-04-11T11:39:55Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-4637e97c40aa4c30b669844b525a62822022-12-22T04:25:51ZengBMCBMC Ophthalmology1471-24152022-09-0122111010.1186/s12886-022-02593-7Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective studyReinhard Angermann0Alexander Franchi1Katharina Frede2Victoria Stöckl3Christoph Palme4Martina Kralinger5Claus Zehetner6Department of Ophthalmology, Medical University InnsbruckDepartment of Ophthalmology, Medical University InnsbruckDepartment of Ophthalmology, Medical University InnsbruckDepartment of Ophthalmology, Medical University InnsbruckDepartment of Ophthalmology, Medical University InnsbruckDepartment of Ophthalmology, Medical University InnsbruckDepartment of Ophthalmology, Medical University InnsbruckAbstract Background This study aimed to analyse the persistence rates of treatment-naïve patients with neovascular age-related macular degeneration (nAMD) who received intravitreal aflibercept therapy in a universal health care system. Methods In this single-centre retrospective cohort study, we audited data of 918 treatment-naïve patients who received exclusively intravitreal aflibercept therapy for nAMD between September 2015 and May 2021. The primary outcome measures were the rates of treatment nonpersistence (gap in ophthalmological care > 6 months) and long-term nonpersistence (> 12 months). Results The rates of nonpersistence and long-term nonpersistence were 12.3% and 3.4% after one year; 22.4% and 9.5% after two years; and 38.3% and 19.3% after five years, respectively. Logistic regression analysis revealed that older age (p = 0.045), male sex (p = 0.039), requirement for caretakers or ambulance (p = 0.001), and low visual acuity of the study eye (p = 0.010) or fellow eye (p = 0.029) were independent risk factors for long-term nonpersistence. Patients aged > 80 and > 85 years (p = 0.013 and p = 0.022, respectively) had more than twice the risk for being nonpersistent to therapy within two years of follow-up compared with younger patients. Male patients (p = 0.033), patients requiring a caretaker (p = 0.038), and patients living > 60 km from the clinic (p = 0.029) had a 2 × higher risk of being persistently nonpersistent to therapy. Conclusions Patients with nAMD who were treated with aflibercept had lower nonpersistence rates than those reported in current literature. Multiple independent risk factors were correlated with long-term nonpersistence, early nonpersistence, or complete loss to follow-up. Considering the possible consequences of reduced compliance, further strategies are urgently needed for patients at risk of nonpersistence to therapy.https://doi.org/10.1186/s12886-022-02593-7AdherenceLong-term effect of complianceLoss to follow-upPersistenceAfliberceptAge-related macular degeneration |
| spellingShingle | Reinhard Angermann Alexander Franchi Katharina Frede Victoria Stöckl Christoph Palme Martina Kralinger Claus Zehetner Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study BMC Ophthalmology Adherence Long-term effect of compliance Loss to follow-up Persistence Aflibercept Age-related macular degeneration |
| title | Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study |
| title_full | Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study |
| title_fullStr | Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study |
| title_full_unstemmed | Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study |
| title_short | Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study |
| title_sort | long term persistence with aflibercept therapy among treatment naive patients with exudative age related macular degeneration in a universal health care system a retrospective study |
| topic | Adherence Long-term effect of compliance Loss to follow-up Persistence Aflibercept Age-related macular degeneration |
| url | https://doi.org/10.1186/s12886-022-02593-7 |
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