title: Treatment Frequency and Dosing Interval of Ranibizumab and Aflibercept for Neovascular Age-Related Macular Degeneration in Routine Clinical Practice in the USA.
abstract: OBJECTIVE
  To compare treatment patterns of intravitreal ranibizumab and aflibercept for the management of neovascular age-related macular degeneration (nAMD) in a real-world setting over the first 12 months of treatment.
  
  
  METHODS
  A proprietary clinical database was used to identify treatment-naïve patients with nAMD in the USA with claims for ranibizumab or aflibercept between November 1, 2011 and November 30, 2013 and with follow-up of at least 12 months. Patients were considered treatment-naïve if they had no anti-VEGF treatment code for 6 months before the index date. Mean numbers of injections and of non-injection visits to a treating physician were compared between the two treatment cohorts (ranibizumab or aflibercept). In addition, the mean interval between doses was also investigated.
  
  
  RESULTS
  Patient characteristics were similar for those receiving either ranibizumab (n = 5421) or aflibercept (n = 3506) at the index date. The mean (± standard deviation) numbers of injections received by patients treated with ranibizumab (4.9 ± 3.3) or aflibercept (5.2 ± 2.9) were not clinically different. The mean number of non-injection visits was 2.8 ± 2.8 and 2.1 ± 2.5 for ranibizumab and aflibercept, respectively. Mean dosing interval was 51.0 days (± 41.8 days) in patients receiving ranibizumab and 54.1 days (± 36.0 days) in those receiving aflibercept. Results were robust to sensitivity analyses for definition of treatment-naïve, length of follow-up and treatment in the index eye only.
  
  
  CONCLUSIONS
  Limited data exist regarding real-world treatment patterns of aflibercept for the management of nAMD. Our results suggest that, in routine clinical practice, patients receive a comparable number of injections in the first year of treatment with ranibizumab or aflibercept.
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ferreira
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Sagkriotis
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Melvin
authors.initials: M
authors.lastname: Olson
authors.affiliation: IMS Health, Plymouth Meeting, PA, United States of America.
authors.forename: Jingsong
authors.initials: J
authors.lastname: Lu
authors.affiliation: IMS Health, Plymouth Meeting, PA, United States of America.
authors.forename: Charles
authors.initials: C
authors.lastname: Makin
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: Fran
authors.initials: F
authors.lastname: Milnes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016208:Databases, Factual; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D000069579:Ranibizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab