title: Treatment patterns of ranibizumab intravitreal injection and dexamethasone intravitreal implant for retinal vein occlusion in the USA.
abstract: PurposeRanibizumab, an anti-vascular endothelial growth factor, and dexamethasone, a corticosteroid, have been shown to be effective in treating macular oedema secondary to retinal vein occlusion (RVO) (central RVO (CRVO) and branch RVO (BRVO)). Their real-world usage, however, has yet to be compared. We therefore evaluated ophthalmology visits for both drugs using US patient-level data.MethodsThe IMS Health Real-World Data Medical Claims database was used to identify treatment-naive patients receiving ranibizumab intravitreal injections or dexamethasone intravitreal implants between June 2010 and February 2014 who had 12 months of follow-up data. The primary outcome measure was the mean number of all ophthalmology visits for the two drugs in patients with CRVO and BRVO. Secondary outcome measures included a comparison of treatment visits, non-treatment visits, and time intervals between visits.ResultsOverall, 2822 patients received ranibizumab injections (CRVO, 1178; BRVO, 1644) and 365 received dexamethasone implants (CRVO, 191; BRVO, 174). The mean number (SD) of all ophthalmology visits was higher for patients receiving ranibizumab injections than for those receiving dexamethasone implants (CRVO: 7.2 (3.6) vs 6.2 (3.1), P<0.001; BRVO: 7.1 (3.4) vs 6.3 (3.1), P=0.016).ConclusionsPatients with RVO receiving ranibizumab injections had a mean of approximately one more visit to their ophthalmologist in the first 12 months of treatment than those treated with dexamethasone implants. The visit burden is therefore not substantially different and physicians should focus on the clinical benefits of these drugs when evaluating treatment options for RVO.
authors.affiliation: Centre Ophtalmologique d'Imagerie et de Laser, Paris, France, Department of Ophthalmology, Hôpital Avicenne, Assistance Publique, Hôpitaux de Paris and Paris 13 University, Bobigny, France.
authors.forename: S
authors.initials: S
authors.lastname: Nghiem-Buffet
authors.affiliation: Department of Ophthalmology, Pasteur II University Hospital, Nice, France.
authors.forename: S
authors.initials: S
authors.lastname: Baillif
authors.affiliation: Novartis Pharma AG, Basel, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Regnier
authors.affiliation: Novartis Ireland Limited, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Skelly
authors.affiliation: Real-World Evidence Solutions, IMS Health, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Yu
authors.affiliation: Department of Ophthalmology, Careggi University Hospital, Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sodi
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004343:Drug Implants / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D012170:Retinal Vein Occlusion / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014481:United States; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004343:Drug Implants; D005938:Glucocorticoids; D042461:Vascular Endothelial Growth Factor A; D003907:Dexamethasone; D000069579:Ranibizumab