Wet AMD Treatment Outcomes Look Misleadingly Better in Clinical Trials
AUGUST 10, 2016
Vision loss is a very real, potential outcome of AMD. Anti-VEGF drugs have shown to successful prevent retinal damage and central vision loss; however, adherence to treatment remains an issue. Outcomes vary when it comes to real-world versus randomized controlled trials. Real-world incidences have poor visual outcomes as well as a 20% to 30% dropout rate within the first year. In a presentation at ASRS 2016, Thomas Ciulla, MD, MBA, an ophthalmologist from Indiana, started off with the three questions the analysis aimed to answer:
1. What are the outcomes?
2. Who is at most risk for vision loss?
3. What is happening with patients lost to follow-up?
To evaluate the risk of vision loss as associated with baseline visual acuity (VA), Ciulla and colleagues reviewed 2,213 patients who were diagnosed with wet AMD at some point from January 2011 to July 2013. All of these patients – 63% female and an average age of 82 – had follow-up data available to July 2015. They had received at least three monthly injections during the first four months.
There were no meaningful differences in number of injections among the three cohorts. Those in the six-month group had an average of five injections, in the 12-month group it was seven injections, and in the 24-month group it was 12 injections.