One year Outcomes of Wet Age-related Macular Degeneration Treatment with Aflibercept in Polish Drug Prescription Program
Wydanie 2/2018
str. 9 – 13
Autorzy: Małgorzata Figurska 1 , Joanna Adamiec-Mroczek 2 , Joanna Dolar-Szczasny 3 , Anna Matysik-Woźniak 4 , Marta Misiuk-Hojło 2 , Anna Święch-Zubilewicz 3 , Sławomir Teper 5 , Magdalena Ulińska 6 , Robert Rejdak 4 , Marek Rękas 1
1 Klinika Okulistyki Wojskowego Instytutu Medycznego, Centralny Szpital Kliniczny Ministerstwa Obrony Narodowej w Warszawie
Kierownik: prof. dr hab. n. med. Marek Rękas
2 Katedra i Klinika Okulistyki Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu
Kierownik: prof. dr hab. n. med. Marta Misiuk-Hojło
3 Klinika Chirurgii Siatkówki i Ciała Szklistego Uniwersytetu Medycznego w Lublinie, Samodzielny Publiczny Szpital Kliniczny Nr 1
Kierownik: dr hab. n. med. Jerzy Mackiewicz
4 Klinika Okulistyki Ogólnej Uniwersytetu Medycznego w Lublinie, Samodzielny Publiczny Szpital Kliniczny Nr 1
Kierownik: prof. dr hab. n. med. Robert Rejdak
5 Oddział Kliniczny Okulistyki, Samodzielny Publiczny Zakład Opieki Zdrowotnej, Okręgowy Szpital Kolejowy w Katowicach
Kierownik: prof. dr hab. n. med. Edward Wylęgała
6 Katedra i Klinika Okulistyki Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego, Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jacek P. Szaflik
Summary: Age-related macular degeneration is a chronic disease, which is the leading cause of blindness in developed countries. The treatment of choice for wet form of degeneration are intravitreal injections of growth factors inhibitors. Purpose: To report one year outcomes of a the Polish drug prescription program using aflibercept in eyes with wet age-related macular degeneration. Methods: This was a non-randomized, retrospective, observational multicenter study of the eyes treated in routine clinical practice between November 2015 and February 2017.
Anonymous data contained in the electronic therapeutic program monitoring system were analyzed. The main outcome measures were change in visual acuity, number of injections and visits during the first year of the treatment program. Results: The study population consisted of 2473 patients (2575 eyes). The median age was 76.0 [70.0, 81.0] years; 61.6% were female. A total number of 1246 (48.4%) eyes were treatment-naïve, and treatment was continued within the program in 1329 (51.6%) eyes.
Best corrected visual acuity increased from 58.86 [50.05, 69.95] letters to 65.1 [50.1, 73.9] letters, (p< 0.001). The median change in best corrected visual acuity was 0.0 [-4.0, 12.8] letters: +3.3 [0.0, 15.1] letters for treatment-naïve eyes, and 0.0 [-4.8, 8.8] letters for those continuing treatment (p< 0.001). The percentage of eyes in which best corrected visual acuity improved by ≥10 letters was significantly higher in treatment-naïve eyes (34,9% vs 24.9%, 34%, p< 0.001).
The median number of visits (without qualification) was 9.0 [8.0, 9.0]. The median number of injections was 7.0 [6.0, 8.0]. The median central retinal thickness reduced significantly from 341.0 μm [280.0, 422.0] to 270.0 μm [219.0, 334.0], p< 0.001.
Conclusions: Patients with wet form of age-related macular degeneration treated with aflibercept as part of the therapeutic program gain functional stability and morphological improvement; treatment-naïve eyes showed the greatest functional benefit.