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    Treatment non-adherence concern

    Studies show high dropout rates for crucial eye injections.

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    Up to a quarter of anti-VEGF patients lost to follow-up

    Two recent studies in the Unites States looking at real-world outcomes for anti-VEGF treatment have found that around 20 – 25 per cent of patients with either wet (neovascular) age-related macular degeneration (AMD) or diabetic macular oedema (DMO) did not have a follow-up visit for at least one year after being treated with an anti-VEGF injection. 

    The first study involved 9,007 patients with wet (neovascular) age-related macular degeneration (AMD) who were treated between 2012 and 2016. The researchers reported that 2,003 patients (22.2 per cent) did not have a follow-up visit for at least one year after receiving one or more anti-VEGF injections.

    The second study involved 1632 patients with diabetic macular oedema (DMO) who were treated between 2012 and 2017. The researchers reported that 413 patients (25.3 per cent) did not have a follow-up visit for at least one year after receiving one or more anti-VEGF injections. 

    Both studies found several risk factors associated with non-adherence to treatment – some of these include older age, lower income, greater distance from clinic to patient’s home, treatment to one eye only and a lower level of vision at the commencement of treatment.  

    The results show that a considerable number of patients with wet AMD or DMO were lost to follow-up after anti-VEGF injections.  

    Because of the importance of ongoing treatment for these conditions, the authors concluded that these real-world findings may help identify patients who may be at risk of non-adherence to treatment. 

    More understanding of the scope of the issue would allow interventions to be designed to improve adherence.   

    Sources: 

    Medical Research article Aug 2018

    Healio article Jan 2019

    Journal articles:

    Obeid A et al. JAMA Opthalmol 2018: doi:10.1001/jamaophthalmol.2018.3578

    Gao X et al. Ophthalmol Retina 2018: doi:10.1016/j.oret.2018.11.002

    Posted: 16 Jan 2019

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