Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy
Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (A...
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| Format: | Article |
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/22/5342 |
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| author | Chiara Altana Matthew Gavino Donadu Stefano Dore Giacomo Boscia Gabriella Carmelita Stefania Zanetti Francesco Boscia Antonio Pinna |
| author_facet | Chiara Altana Matthew Gavino Donadu Stefano Dore Giacomo Boscia Gabriella Carmelita Stefania Zanetti Francesco Boscia Antonio Pinna |
| author_sort | Chiara Altana |
| collection | DOAJ |
| description | Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (ADRs), and intravitreal drug expenses were assessed. Methods: All DME patients treated with Ranibizumab, Aflibercept, Dexamethasone implant, and Fluocinolone Acetonide implant at the Sassari University Hospital, Italy, between January 2017 and June 2020 were included. Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured. ADRs and drug expenses were analyzed. Results: Two-hundred thirty-one DME patients (mean age: 65 years) received intravitreal agents. Mean CMT and BCVA were 380 μm and 0.5 LogMAR at baseline, 298 μm and 0.44 logMAR after one year (<i>p</i> = 0.04), and 295 μm and 0.4 logMAR at the end of the follow-up period. A total of 1501 intravitreal injections were given; no major ADRs were reported. Treatment cost was €915,000 (€261,429/year). Twenty non-responders to Ranibizumab or Aflibercept were switched to a Dexamethasone implant. In these patients, mean CMT and BCVA were 468 µm and 0.5 LogMar at the time of switching and 362 µm and 0.3 LogMar at the end of the follow-up (<i>p</i> = 0.00014 and <i>p</i> = 0.08, respectively). Conclusion: Results confirm that Ranibizumab, Aflibercept, and Dexamethasone implant are effective and safe in DME treatment. A switch to Dexamethasone implant for patients receiving Aflibercept or Ranibizumab with minimal/no clinical benefit should be considered. |
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| language | English |
| last_indexed | 2024-03-10T05:23:47Z |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-8218c4fb2299497e866f8a7d336ebd702023-11-22T23:49:59ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011022534210.3390/jcm10225342Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, ItalyChiara Altana0Matthew Gavino Donadu1Stefano Dore2Giacomo Boscia3Gabriella Carmelita4Stefania Zanetti5Francesco Boscia6Antonio Pinna7Hospital Pharmacy, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, ItalyHospital Pharmacy, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, ItalyOphthalmology Unit, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyHospital Pharmacy, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, ItalyDepartment of Biomedical Sciences, University of Sassari, 07100 Sassari, ItalySection of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari, 70124 Bari, ItalyOphthalmology Unit, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, ItalyBackground: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (ADRs), and intravitreal drug expenses were assessed. Methods: All DME patients treated with Ranibizumab, Aflibercept, Dexamethasone implant, and Fluocinolone Acetonide implant at the Sassari University Hospital, Italy, between January 2017 and June 2020 were included. Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured. ADRs and drug expenses were analyzed. Results: Two-hundred thirty-one DME patients (mean age: 65 years) received intravitreal agents. Mean CMT and BCVA were 380 μm and 0.5 LogMAR at baseline, 298 μm and 0.44 logMAR after one year (<i>p</i> = 0.04), and 295 μm and 0.4 logMAR at the end of the follow-up period. A total of 1501 intravitreal injections were given; no major ADRs were reported. Treatment cost was €915,000 (€261,429/year). Twenty non-responders to Ranibizumab or Aflibercept were switched to a Dexamethasone implant. In these patients, mean CMT and BCVA were 468 µm and 0.5 LogMar at the time of switching and 362 µm and 0.3 LogMar at the end of the follow-up (<i>p</i> = 0.00014 and <i>p</i> = 0.08, respectively). Conclusion: Results confirm that Ranibizumab, Aflibercept, and Dexamethasone implant are effective and safe in DME treatment. A switch to Dexamethasone implant for patients receiving Aflibercept or Ranibizumab with minimal/no clinical benefit should be considered.https://www.mdpi.com/2077-0383/10/22/5342diabetic macular edemaintravitreal agentsbest corrected visual acuitycentral retinal thicknessadverse drug reactionsintravitreal drug expenses |
| spellingShingle | Chiara Altana Matthew Gavino Donadu Stefano Dore Giacomo Boscia Gabriella Carmelita Stefania Zanetti Francesco Boscia Antonio Pinna Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy Journal of Clinical Medicine diabetic macular edema intravitreal agents best corrected visual acuity central retinal thickness adverse drug reactions intravitreal drug expenses |
| title | Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy |
| title_full | Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy |
| title_fullStr | Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy |
| title_full_unstemmed | Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy |
| title_short | Clinical Outcome and Drug Expenses of Intravitreal Therapy for Diabetic Macular Edema: A Retrospective Study in Sardinia, Italy |
| title_sort | clinical outcome and drug expenses of intravitreal therapy for diabetic macular edema a retrospective study in sardinia italy |
| topic | diabetic macular edema intravitreal agents best corrected visual acuity central retinal thickness adverse drug reactions intravitreal drug expenses |
| url | https://www.mdpi.com/2077-0383/10/22/5342 |
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