Evidence map›Paper›PMID 36123657›Full record

ArticleBMC ophthalmology2022

Long-term persistence with aflibercept therapy among treatment-naïve patients with exudative age-related macular degeneration in a universal health care system: a retrospective study.

Reinhard Angermann, Alexander Franchi, Katharina Frede, Victoria Stöckl, Christoph Palme, Martina Kralinger, Claus Zehetner

Open access · goldAbstract read
In one paragraph

Article in BMC ophthalmology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Reinhard AngermannDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Alexander FranchiDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Katharina FredeDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Victoria StöcklDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Christoph PalmeDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Martina KralingerDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Claus ZehetnerDepartment of Ophthalmology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. claus.zehetner@i-med.ac.at.
Innsbruck Medical University · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study  aimed to analyse the persistence rates of treatment-naïve patients with neovascular age-related macular degeneration (nAMD) who received intravitreal aflibercept therapy in a universal health care system.

methodsIn this single-centre retrospective cohort study, we audited data of 918 treatment-naïve patients who received exclusively intravitreal aflibercept therapy for nAMD between September 2015 and May 2021. The primary outcome measures were the rates of treatment nonpersistence (gap in ophthalmological care > 6 months) and long-term nonpersistence (> 12 months).

resultsThe rates of nonpersistence and long-term nonpersistence were 12.3% and 3.4% after one year; 22.4% and 9.5% after two years; and 38.3% and 19.3% after five years, respectively. Logistic regression analysis revealed that older age (p = 0.045), male sex (p = 0.039), requirement for caretakers or ambulance (p = 0.001), and low visual acuity of the study eye (p = 0.010) or fellow eye (p = 0.029) were independent risk factors for long-term nonpersistence. Patients aged > 80 and > 85 years (p = 0.013 and p = 0.022, respectively) had more than twice the risk for being nonpersistent to therapy within two years of follow-up compared with younger patients. Male patients (p = 0.033), patients requiring a caretaker (p = 0.038), and patients living > 60 km from the clinic (p = 0.029) had a 2 × higher risk of being persistently nonpersistent to therapy.

conclusionsPatients with nAMD who were treated with aflibercept had lower nonpersistence rates than those reported in current literature. Multiple independent risk factors were correlated with long-term nonpersistence, early nonpersistence, or complete loss to follow-up. Considering the possible consequences of reduced compliance, further strategies are urgently needed for patients at risk of nonpersistence to therapy.

Indexed as

Macular DegenerationUniversal Health CareAngiogenesis InhibitorsHumansIntravitreal InjectionsMaleReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsRetrospective StudiesTomography, Optical CoherenceVisual AcuityafliberceptAngiogenesis InhibitorsReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsAdherenceAfliberceptAge-related macular degenerationLong-term effect of complianceLoss to follow-upPersistence

Identifiers

PMID36123657
PMCPMC9483893
OpenAlexW4296350550

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.