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. 2024 Oct 3;19(10):e0310381.
doi: 10.1371/journal.pone.0310381. eCollection 2024.

Real-world visual acuity outcomes for patients with naïve neovascular age-related macular degeneration treated with aflibercept, ranibizumab, or bevacizumab in the Republic of Korea

Yeo Jin Lee  1   2 , Seungbum Kang  1   3 , Jae Yon Won  1   2 , Young Jung Roh  1   4 , Ho Ra  1   5 , Mee Yon Lee  1   6 , Sung Pyo Park  1   7 , Dong Hyun Jee  1   8
Affiliations

Real-world visual acuity outcomes for patients with naïve neovascular age-related macular degeneration treated with aflibercept, ranibizumab, or bevacizumab in the Republic of Korea

Yeo Jin Lee et al. PLoS One. .

Abstract

Background: To compare the visual outcomes of different anti-vascular endothelial growth factor (VEGF) drugs, including aflibercept, ranibizumab, and bevacizumab, in a real-world setting in Korea.

Methods: We collected data from patients who received monotherapy using one of these three anti-VEGF drugs as naïve treatment after being diagnosed with neovascular age-related macular degeneration. The number of injections and visual acuity (VA) outcomes of each cohort were obtained and pairwise comparisons were performed using propensity score matching.

Results: A total of 254 aflibercept, 238 ranibizumab, and 282 bevacizumab treatment-naïve eyes were included. The mean VA change at 3 years for all cohorts combined was -1.8 letters, and the mean number of injections was 9.4. In the direct comparison of the three drugs, the mean change in the VA letter score was +2.0 letters for aflibercept and -11.7 letters for bevacizumab (P < 0.001). The number of aflibercept injections was significantly higher than the number of bevacizumab injections (P = 0.002). The visual outcomes for aflibercept and ranibizumab were +4.7 letters and -1.9 letters, respectively, and comparable results were obtained (P = 0.13). The VA outcomes for ranibizumab and bevacizumab were also not significantly different (P = 0.09). The numbers of injections for aflibercept, ranibizumab, and bevacizumab were 10.8, 6.7, and 8.8, respectively. Significant differences were observed between the injection frequencies comparisons of aflibercept and ranibizumab and ranibizumab and bevacizumab (P < 0.001 and P = 0.002, respectively).

Conclusions: In the Korean clinical medical environment, which included various confounding factors, especially socioeconomic ones, the aflibercept VA outcome was significantly better than that of bevacizumab, and aflibercept injections were the most numerous. These real-world data imply that the drug effect as well as the environment in which the drug can be sufficiently used affected patient final VA scores.

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Conflict of interest statement

NO authors have competing interests

Figures

Fig 1
Fig 1
A. Flow charts of the enrolled population B. Propensity score–matched cohort for pairwise comparison.
Fig 2
Fig 2. Change in mean visual acuity of all patients.
Fig 3
Fig 3. Visual acuity change in each mono-therapy cohort.
Fig 4
Fig 4. Mean change in visual acuity score from baseline.
Fig 5
Fig 5. Difference in mean change in visual acuity score.
See this image and copyright information in PMC

References

    1. Quillen DA. Common causes of vision loss in elderly patients. American family physician. 1999;60(1):99–108. - PubMed
    1. Congdon N O’Colmain B, Klaver C, Klein R, Muñoz B, Friedman DS et al.. Causes and prevalence of visual impairment among adults in the United States. Archives of Ophthalmology (Chicago, Ill: 1960). 2004;122(4):477–85. doi: 10.1001/archopht.122.4.477 - DOI - PubMed
    1. Kovach JL, Schwartz SG, Flynn HW, Scott IU. Anti-VEGF treatment strategies for wet AMD. Journal of ophthalmology. 2012;2012. doi: 10.1155/2012/786870 - DOI - PMC - PubMed
    1. Mehta H, Tufail A, Daien V, Lee AY, Nguyen V, Ozturk M, et al.. Real-world outcomes in patients with neovascular age-related macular degeneration treated with intravitreal vascular endothelial growth factor inhibitors. Progress in retinal and eye research. 2018;65:127–46. doi: 10.1016/j.preteyeres.2017.12.002 - DOI - PubMed
    1. Martin DF, Maguire MG, Ying G, Grunwald JE, Fine SL, Jaffe GJ. Ranibizumab and bevacizumab for neovascular age-related macular degeneration. The New England journal of medicine. 2011;364(20):1897–908. doi: 10.1056/NEJMoa1102673 - DOI - PMC - PubMed

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