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Risk Factors for Discontinuation of Treatment for Neovascular Age-Related Macular Degeneration

Westborg, Inger and Rosso, Aldana LU (2018) In Ophthalmic Epidemiology 25(2). p.176-182
Abstract

PURPOSE: To investigate risk factors for treatment discontinuation for neovascular age-related macular degeneration (nAMD).

METHODS: Data from the Swedish Macula Register and the Skåne Healthcare Register are reported on the treatment received by 932 nAMD patients diagnosed 2013-2015. Treatment discontinuation is defined as having a termination visit or lacking a control or treatment visit during the period of 10-14 months after the diagnostic visit. The risk of treatment discontinuation during the first year is estimated using a Poisson model and a classification tree.

RESULTS: 503 eyes (50.9%) discontinued the treatment within the first year. Patients with visual acuity below 60 ETDRS letters (20/60 Snellen) at baseline,... (More)

PURPOSE: To investigate risk factors for treatment discontinuation for neovascular age-related macular degeneration (nAMD).

METHODS: Data from the Swedish Macula Register and the Skåne Healthcare Register are reported on the treatment received by 932 nAMD patients diagnosed 2013-2015. Treatment discontinuation is defined as having a termination visit or lacking a control or treatment visit during the period of 10-14 months after the diagnostic visit. The risk of treatment discontinuation during the first year is estimated using a Poisson model and a classification tree.

RESULTS: 503 eyes (50.9%) discontinued the treatment within the first year. Patients with visual acuity below 60 ETDRS letters (20/60 Snellen) at baseline, serious comorbidities, or treated at the university hospital have a 42% (95% CI 25-61%, P < 0.001), 27% (95% CI 13-43%, P = 0.001) and 30% (95% CI 15-46%, P < 0.001) increased risk to discontinue treatment compared with similar patients. Patients on ranibizumab therapy have a 45% (95% CI 28-63%, P < 0.001) increased risk for treatment discontinuation during year 1 compared with patients on aflibercept therapy. The classification tree also shows that patients on ranibizumab therapy and those with low VA at baseline are at a higher risk of terminating treatment.

CONCLUSIONS: Almost half of the patients starting anti-VEGF therapy discontinue treatment during the first year. Patients with risk factors may require additional support to continue with the treatment. Aflibercept therapy could be an alternative to patients at risk of treatment discontinuation.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Journal Article
in
Ophthalmic Epidemiology
volume
25
issue
2
pages
176 - 182
publisher
Informa Healthcare
external identifiers
  • scopus:85033674917
ISSN
0928-6586
DOI
10.1080/09286586.2017.1397701
language
English
LU publication?
yes
id
f3bfc7aa-24eb-4902-8ada-156cba5c2443
date added to LUP
2017-11-21 15:51:25
date last changed
2018-02-09 14:41:24
@article{f3bfc7aa-24eb-4902-8ada-156cba5c2443,
  abstract     = {<p>PURPOSE: To investigate risk factors for treatment discontinuation for neovascular age-related macular degeneration (nAMD).</p><p>METHODS: Data from the Swedish Macula Register and the Skåne Healthcare Register are reported on the treatment received by 932 nAMD patients diagnosed 2013-2015. Treatment discontinuation is defined as having a termination visit or lacking a control or treatment visit during the period of 10-14 months after the diagnostic visit. The risk of treatment discontinuation during the first year is estimated using a Poisson model and a classification tree.</p><p>RESULTS: 503 eyes (50.9%) discontinued the treatment within the first year. Patients with visual acuity below 60 ETDRS letters (20/60 Snellen) at baseline, serious comorbidities, or treated at the university hospital have a 42% (95% CI 25-61%, P &lt; 0.001), 27% (95% CI 13-43%, P = 0.001) and 30% (95% CI 15-46%, P &lt; 0.001) increased risk to discontinue treatment compared with similar patients. Patients on ranibizumab therapy have a 45% (95% CI 28-63%, P &lt; 0.001) increased risk for treatment discontinuation during year 1 compared with patients on aflibercept therapy. The classification tree also shows that patients on ranibizumab therapy and those with low VA at baseline are at a higher risk of terminating treatment.</p><p>CONCLUSIONS: Almost half of the patients starting anti-VEGF therapy discontinue treatment during the first year. Patients with risk factors may require additional support to continue with the treatment. Aflibercept therapy could be an alternative to patients at risk of treatment discontinuation.</p>},
  author       = {Westborg, Inger and Rosso, Aldana},
  issn         = {0928-6586},
  keyword      = {Journal Article},
  language     = {eng},
  number       = {2},
  pages        = {176--182},
  publisher    = {Informa Healthcare},
  series       = {Ophthalmic Epidemiology},
  title        = {Risk Factors for Discontinuation of Treatment for Neovascular Age-Related Macular Degeneration},
  url          = {http://dx.doi.org/10.1080/09286586.2017.1397701},
  volume       = {25},
  year         = {2018},
}