Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-08-01 Epub Date: 2025-06-15 DOI:10.1007/s40123-025-01178-z

H Mhmud, J P Vermeulen, O A M Tigchelaar-Besling, F D Verbraak, D Barthelmes, M Gillies, T L Ponsioen, Caroline C W Klaver

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引用次数: 0

Abstract

Introduction: To evaluate long-term outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) in the Netherlands (NL), where bevacizumab is the mandated first-line drug, compared to high-income countries using ranibizumab or aflibercept as initial treatments.

Methods: Five-year data from the Fight Retinal Blindness! (FRB) registry, a real-world prospective registry, were analyzed. Outcomes from 1473 Dutch eyes (1229 patients) treated with bevacizumab were compared with 7144 eyes (5884 patients) in a reference group (RG) from 13 socioeconomically similar countries. The primary outcome was mean visual acuity (VA) at yearly intervals; secondary outcomes included injection frequency and switching rates to alternative anti-VEGF agents.

Results: Throughout the 60 months, mean VA was consistently higher in Dutch eyes (baseline: NL 60.2 vs. RG 59.2; 60 months: NL 64.9 vs. RG 62.6). The Dutch group cumulatively received 14.5 more injections over 5 years and had a higher rate of switching (70.9% vs. 50.9%) with a shorter median time to switching (11.9 months vs. 17.7 months).

Conclusions: Patients treated in Dutch FRB! clinics have good long-term outcomes with a 2.3-letter higher mean VA at the 60-month timepoint compared to FRB! clinics in the RG. The Dutch patients, who began treatment with bevacizumab, received 14.5 more injections over 5 years and had a 40% higher rate of switching to an alternative drug, with switching occurring 5.8 months earlier. This study highlights the benefits of early and more intensive management to optimize visual outcomes, which appear more important than the choice and price of the first-line drug.

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贝伐单抗作为一线抗vegf治疗的年龄相关性黄斑变性的5年真实预后

在荷兰（NL），贝伐单抗是强制性的一线药物，与使用雷尼单抗或阿非利塞普作为初始治疗的高收入国家相比，评估抗vegf治疗新生血管性年龄相关性黄斑变性（nAMD）的长期结果。方法：“抗击视网膜失明！”（FRB）登记，一个真实世界的前瞻性登记。使用贝伐单抗治疗的1473只荷兰眼睛（1229例患者）与来自13个社会经济相似国家的参考组（RG）的7144只眼睛（5884例患者）的结果进行了比较。主要指标为平均视力（VA），每隔一年；次要结局包括注射频率和替代抗vegf药物的转换率。结果：在整个60个月中，荷兰眼的平均VA持续较高(基线：NL 60.2 vs RG 59.2；60个月：NL 64.9 vs RG 62.6)。荷兰组在5年内累计接受了14.5次注射，转换率更高（70.9%对50.9%），转换的中位时间更短（11.9个月对17.7个月）。结论：荷兰FRB患者治疗！临床有良好的长期结果，在60个月的时间点上，与FRB相比，平均VA高2.3个字母！RG的诊所。开始使用贝伐单抗治疗的荷兰患者在5年内接受了14.5次注射，并且转换为替代药物的比例高出40%，转换发生在5.8个月前。这项研究强调了早期和更密集的管理对优化视力结果的好处，这似乎比一线药物的选择和价格更重要。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. 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