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Anti-VEGF treatment patterns for neovascular age-related macular degeneration among medicare beneficiaries.

Publication ,  Journal Article
Lad, EM; Hammill, BG; Qualls, LG; Wang, F; Cousins, SW; Curtis, LH
Published in: Am J Ophthalmol
September 2014

PURPOSE: To examine the use of anti-vascular endothelial growth factor (VEGF) therapy in clinical practice among patients with neovascular age-related macular degeneration (AMD). DESIGN: Retrospective cohort study. METHODS: Among 459 237 Medicare beneficiaries, we identified anti-VEGF treatment using claims for intravitreal injections of anti-VEGF medications with a supporting diagnosis of neovascular AMD. We used the cumulative incidence function to calculate the frequency of anti-VEGF treatments and treatment visits for neovascular AMD per treated eye in the first and second year after the initial anti-VEGF injection. We calculated the mean number of treatments and treatment visits per eye using the mean frequency function. Rates of discontinuation were estimated using Kaplan-Meier methods. RESULTS: The mean number of injections was 4.3 in the first year, with 58% of patients receiving 1-4 injections, 20% receiving 5-6 injections, and 22% receiving 7 or more injections. Among patients who received 7 or more injections during the first year, 31% received a comparable number during the second year, and 12% received no injections. Of patients who received 1-4 injections during the first year, 70% received no injections and 24% received 1-4 injections during the second year. Rates of anti-VEGF discontinuation were 57% within 12 months and 71% within 24 months. CONCLUSIONS: The frequency of anti-VEGF injections for neovascular AMD was lower than that recommended by large-scale clinical trials, and rates of discontinuation were high. National practice patterns in anti-VEGF therapy for patients with neovascular AMD do not reflect optimal treatment strategies suggested by recent clinical trial evidence.

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Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

September 2014

Volume

158

Issue

3

Start / End Page

537 / 43.e2

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Retinal Neovascularization
  • Ranibizumab
  • Ophthalmology & Optometry
  • Medicare
  • Male
  • Macular Degeneration
 

Citation

APA
Chicago
ICMJE
MLA
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Lad, E. M., Hammill, B. G., Qualls, L. G., Wang, F., Cousins, S. W., & Curtis, L. H. (2014). Anti-VEGF treatment patterns for neovascular age-related macular degeneration among medicare beneficiaries. Am J Ophthalmol, 158(3), 537-43.e2. https://doi.org/10.1016/j.ajo.2014.05.014
Lad, Eleonora M., Bradley G. Hammill, Laura G. Qualls, Fang Wang, Scott W. Cousins, and Lesley H. Curtis. “Anti-VEGF treatment patterns for neovascular age-related macular degeneration among medicare beneficiaries.Am J Ophthalmol 158, no. 3 (September 2014): 537-43.e2. https://doi.org/10.1016/j.ajo.2014.05.014.
Lad EM, Hammill BG, Qualls LG, Wang F, Cousins SW, Curtis LH. Anti-VEGF treatment patterns for neovascular age-related macular degeneration among medicare beneficiaries. Am J Ophthalmol. 2014 Sep;158(3):537-43.e2.
Lad, Eleonora M., et al. “Anti-VEGF treatment patterns for neovascular age-related macular degeneration among medicare beneficiaries.Am J Ophthalmol, vol. 158, no. 3, Sept. 2014, pp. 537-43.e2. Pubmed, doi:10.1016/j.ajo.2014.05.014.
Lad EM, Hammill BG, Qualls LG, Wang F, Cousins SW, Curtis LH. Anti-VEGF treatment patterns for neovascular age-related macular degeneration among medicare beneficiaries. Am J Ophthalmol. 2014 Sep;158(3):537–43.e2.
Journal cover image

Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

September 2014

Volume

158

Issue

3

Start / End Page

537 / 43.e2

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • United States
  • Treatment Outcome
  • Retrospective Studies
  • Retinal Neovascularization
  • Ranibizumab
  • Ophthalmology & Optometry
  • Medicare
  • Male
  • Macular Degeneration