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A pharmacoepidemiologic study of ranibizumab and aflibercept use 2013–2016. The Fight Retinal Blindness! Project

  • Retinal Disorders
  • Published:
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Abstract

Introduction

To report 12-month pharmacoepidemiologic data on aflibercept and ranibizumab use in treatment-naïve eyes with neovascular age-related macular degeneration (nAMD).

Methods

Participants were treatment-naïve eyes with nAMD tracked by the Fight Retinal Blindness! registry starting therapy with aflibercept or ranibizumab treatment between January 1st, 2013 and 31st December, 2016. Demographic and clinical characteristics were compared between treatment groups.

Results

During the study period, 689 eyes initiated treatment with ranibizumab compared to 568 with aflibercept. We found a similar rate of use of both drugs. Ranibizumab-treated patients were older than aflibercept-treated patients (overall mean [SD] 82.0 [8.4] vs. 78.6 [8.1], P < 0.001). Median (Q1, Q3) lesion size was significantly larger in aflibercept-treated patients (2450 μm [1242, 3000]) compared with ranibizumab patients (2000 μm [1148, 2890], P = 0.008). Eyes treated with ranibizumab and aflibercept received a similar mean number of injections in the first 3 months (3.1 [0.7] vs. 3.0 [0.6]; P = 0.233) and at 12 months (7.3 [2.4] vs. 7.2 [2.2]; P = 0.139). The 12-month switching rates from 2013 onwards for eyes completing 12 months of follow-up were much higher for switching from ranibizumab to aflibercept (19.2%) compared with switching from aflibercept to ranibizumab (5.4%). The proportion of eyes that did not complete 12 months of treatment was 23.2% for ranibizumab and 22.2% for aflibercept-treated groups.

Conclusion

A similar rate of use for ranibizumab and aflibercept among Australian practitioners was observed between 2013 and 2016. Ranibizumab was used more often in older patients while aflibercept tended to be used more often in eyes with larger lesions.

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Acknowledgements

Fight Retinal Blindness! investigators: Armadale Eye Clinic, VIC (Dr. A Cohn); Bunbury and Busselton Eye Doctors, WA (Dr. R Barry); Bundaberg Eye Clinic, QLD (Dr. I McLean); Cairns Eye Surgery, QLD (Dr. A Field); Canberra Hospital, ACT (Dr. C Dayajeewa, Dr. R Essex); Care Foresight, NSW (Dr. A Dunlop); Caulfield Eye Clinic, VIC (Dr. C Ng); Central Coast Eye Specialist, NSW (Dr. S Young); Centre for Eye Research Australia, VIC (Professor R Guymer); Doncaster Eye Centre, VIC (Dr. L Chow); Dorset Consultant Centre, VIC (Dr. H Steiner); Dr. Alex Amini’s Practice, VIC (Dr. A Amini); Dr. Clarks Practice, NSW (Dr. G Clark); Dr. Phillip Windle, QLD (Dr. P Windle); Eye Associates, NSW (Dr. M Gillies, Dr. A Hunt); Eyemedics, SA (Dr. J Chen, Dr. M Perks, Dr. N Saha, Dr. S Lake); Gladesville Eye Specialists, NSW (Dr. S Young); Hawthorn Eye Clinic, VIC (Dr. L Chow); Hornsby Eye Specialists, NSW (Dr. S Lal); Les Manning Practice, QLD (Dr. L Manning); Marsden Eye Specialists, NSW (Dr. J Arnold, Dr. H Cass); Midwest Ophthalmology, NSW (Dr. K Tang); Nepean Valley Eye Surgeons, NSW (Dr. G Banerjee); New England Eye Centre, NSW (Dr. M Morgan); Port Macquarie Eye Centre, NSW (Dr. J Game, Dr. C Thompson); Retina Associates, NSW (Dr. S Fraser-Bell, Dr. C Younan, Dr. A Hunyor); Retina Consultants, NSW (Dr. S Young); Southeastern Eye Care, NSW (Dr. B Swamy); Specialist Eye Group, VIC (Dr. A Cohn, Dr. L Chow); Sydney Eye Hospital, NSW; Tamworth Eye Centre, NSW (Dr. P Hinchcliffe); Victoria Parade Eye Consultants, VIC (Dr. M Daniell, Prof. R Guymer, Dr. A Harper, Dr. J O’Day, Dr. L Lim); Victorian Eye Surgeons, VIC (Dr. A Cohn).

Funding

This study was supported by a grant from the Royal Australian NZ College of Ophthalmologists Eye Foundation (2007–2009), a grant from the National Health and Medical Research Council, Australia (NHMRC 2010–2012) and a grant from the Macular Disease Foundation, Australia. Funding was also provided by Novartis and Bayer. These sponsors had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Daniel Barthelmes

  2. The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia

    Daniel Barthelmes, Vuong Nguyen, Richard Walton, Mark C. Gillies & Vincent Daien

  3. Department of Ophthalmology, Montpellier University Hospital, Montpellier, France

    Vincent Daien

  4. National Institute of Health and Medical Research, INSERM 1061 unit, Villejuif, France

    Vincent Daien

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  1. Daniel Barthelmes
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the Fight Retinal Blindness Study Group

Corresponding author

Correspondence to Vincent Daien.

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Conflict of interest

The authors state they have no conflicts of interest to declare. Mark Gillies is a Sydney Medical Foundation Fellow and is supported by an NHMRC practitioner fellowship. Daniel Barthelmes was supported by the Walter and Gertrud Siegenthaler Foundation Zurich, Switzerland and the Swiss National Foundation. Vincent Daien was supported by the research grant of the French Society of Ophthalmology.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. For this type of study, formal consent is not required.

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Barthelmes, D., Nguyen, V., Walton, R. et al. A pharmacoepidemiologic study of ranibizumab and aflibercept use 2013–2016. The Fight Retinal Blindness! Project. Graefes Arch Clin Exp Ophthalmol 256, 1839–1846 (2018). https://doi.org/10.1007/s00417-018-4061-2

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  • DOI: https://doi.org/10.1007/s00417-018-4061-2

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