Academic Journal
Simulation of long-term impact of intravitreal anti-VEGF therapy on patients with severe non-proliferative diabetic retinopathy
| العنوان: | Simulation of long-term impact of intravitreal anti-VEGF therapy on patients with severe non-proliferative diabetic retinopathy |
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| المؤلفون: | Nguyen, Quan Dong, Moshfeghi, Andrew A, Lim, Jennifer I, Ponomareva, Ekaterina, Chauhan, Ankita, Rao, Rohini, Sherman, Steven |
| المساهمون: | Regeneron Pharmaceuticals |
| المصدر: | BMJ Open Ophthalmology ; volume 8, issue 1, page e001190 ; ISSN 2397-3269 |
| بيانات النشر: | BMJ |
| سنة النشر: | 2023 |
| الوصف: | Objective A simulation model was constructed to assess long-term outcomes of proactively treating severe non-proliferative diabetic retinopathy (NPDR) with anti-vascular endothelial growth factor (anti-VEGF) therapy versus delaying treatment until PDR develops. Methods and analysis Simulated patients were generated using a retrospective real-world cohort of treatment-naive patients identified in an electronic medical records database (IBM Explorys) between 2011 and 2017. Impact of anti-VEGF treatment was derived from clinical trial data for intravitreal aflibercept (PANORAMA) and ranibizumab (RISE/RIDE), averaged by weighted US market share. Real-world risk of PDR progression was modelled using Cox multivariable regression. The Monte Carlo simulation model examined rates of progression to PDR and sustained blindness (visual acuity <20/200) for 2 million patients scaled to US NPDR disease prevalence. Simulated progression rates from severe NPDR to PDR over 5 years and blindness rates over 10 years were compared for delayed versus early-treatment patients. Results Real-world data from 77 454 patients with mild-to-severe NPDR simulated 2 million NPDR patients, of which 86 680 had severe NPDR. Early treatment of severe NPDR with anti-VEGF therapy led to a 51.7% relative risk reduction in PDR events over 5 years (15 704 early vs 32 488 delayed), with a 19.4% absolute risk reduction (18.1% vs 37.5%). Sustained blindness rates at 10 years were 4.4% for delayed and 1.9% for early treatment of severe NPDR. Conclusion The model suggests treating severe NPDR early with anti-VEGF therapy, rather than delaying treatment until PDR develops, could significantly reduce PDR incidence over 5 years and sustained blindness over 10 years. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1136/bmjophth-2022-001190 |
| الاتاحة: | http://dx.doi.org/10.1136/bmjophth-2022-001190 https://syndication.highwire.org/content/doi/10.1136/bmjophth-2022-001190 |
| Rights: | http://creativecommons.org/licenses/by-nc/4.0/ |
| رقم الانضمام: | edsbas.A70E679A |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/bmjophth-2022-001190 |
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