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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Aflibercept in exudative age related macular degeneration refractory to ranibizu...
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Vol. 90. Issue 12.
Pages 566-571 (December 2015)
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Vol. 90. Issue 12.
Pages 566-571 (December 2015)
Original article
Aflibercept in exudative age related macular degeneration refractory to ranibizumab
Resultados de aflibercept en degeneración macular asociada a la edad refractaria a ranibizumab
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J. Ruiz Ramosa,
Corresponding author
jrzrms@gmail.com

Corresponding author.
, I. Pascual-Campsb, M.J. Cuéllar-Monreala, R. Dolz-Marcob, M.A. Fenollb, I. Font-Nogueraa, J.L. Poveda-Andrésa, R. Gallego-Pinazob
a Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
b Servicio de Oftalmología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Tables (2)
Table 1. Direct medical costs considered by the study.
Table 2. Characteristics of patients treated with aflibercept (n=46).
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Abstract
Purpose

The aim of this study is to determine the effectiveness, safety and cost of aflibercept in the treatment of wet age-related macular degeneration (ARMD) refractory to ranibizumab.

Methods

Retrospective observational study was conducted on patients diagnosed with wet ARMD, and previously treated with ranibizumab. Efficacy variables assessed were changes in visual acuity (BCVA) and anatomical improvements in the most affected eye. Factors associated with improvement of BCVA with aflibercept were also studied. Adverse events related to the aflibercept administration were recorded. Cost analysis data were collected from the hospital perspective, and only taking the direct medical costs into account. Cost-effectiveness analysis was calculated using the aflibercept treatment cost, and effectiveness calculated as BCVA gained.

Results

A total of 50 eyes corresponding to 46 patients were included. The median follow-up period was 4.6 months (range: 1.0–6.0). Improvement in visual acuity after the first 2 doses and at the end of the follow-up period was observed in 32.0 and 28.0% of treated eyes, respectively. None of the variables studied was associated with an improvement in the BCVA after treatment. No significant differences were found in the average monthly cost between treatments.

Conclusions

Aflibercept is shown to be an effective treatment in a significant number of patients resistant to treatment with ranibizumab, presenting a cost similar to that generated during the final stages of treatment with ranibizumab.

Keywords:
Aflibercept
Ranibizumab
Macular degeneration
Cost-effectiveness
Visual acuity
Resumen
Objetivo

El objetivo de este estudio es analizar la efectividad, seguridad y costes de aflibercept en el tratamiento de la degeneración macular relacionada con la edad (DMAE) refractaria al ranibizumab.

Métodos

Estudio observacional retrospectivo en el que se incluyó a pacientes diagnosticados de DMAE húmeda tratados previamente con ranibizumab. Las variables de eficacia evaluadas fueron cambios en la agudeza visual corregida (AV) y mejoras anatómicas en el ojo más afectado. Se estudiaron factores asociados a la mejora de la AV con aflibercept. Se recogieron los eventos adversos relacionados con el tratamiento. El análisis de costes se realizó desde la perspectiva del hospital, teniendo en cuenta solo los costos médicos directos. El análisis coste-efectividad respecto a la terapia previa con ranibizumab se calculó mediante el coste del tratamiento y la efectividad del tratamiento calculada como AV ganada.

Resultados

Se incluyeron un total de 50 ojos correspondientes a 46 pacientes, con una mediana de seguimiento de 4,6 meses (rango: 1,0–6,0). El porcentaje de ojos tratados que mostraron una mejora en la AV después de las 2 primeras dosis y al final del período de seguimiento fue de 32,0 y 28,0%. Ninguna de las variables estudiadas se asoció con una mejoría en la AV corregida después del tratamiento. No se encontraron diferencias significativas en el coste medio mensual entre tratamientos.

Conclusiones

Aflibercept es un tratamiento efectivo en un número significativo de pacientes resistentes al tratamiento con ranibizumab, con un coste similar al generado durante las etapas finales de tratamiento con ranibizumab.

Palabras clave:
Aflibercept
Ranibizumab
Degeneración macular
Coste-efectividad
Agudeza visual

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