Treatment outcomes for nAMD, DMO, RVO poorer in clinical practice than in trials

In clinical practice, patients with neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DMO), and retinal vein occlusion (RVO) see treatment outcomes that are inferior to those reported in pivotal phase 3 studies, according to a recent study.

The study included 3,802 nAMD, 975 DMO, 357 branch RVO, 54 hemi-RVO, and 371 central RVO eyes treated with aflibercept or ranibizumab from 2015 to 2019.

For each year, 12-month mean change in visual acuity (VA) remained stable or showed no notable change over time in nAMD eyes, which saw an increase of 3.3 to 6 letters. A similar effect was reported for DMO eyes, which had a mean VA increase of 3.6 to 6.7 letters.

The same was true for RVO eyes, regardless of occlusion type. Mean VA increase was 10.3 to 11.7 letters in branch RVO, 5.9 to 17.7 letters in central RVO, and 10.2 to 20.7 letters in hemi-RVO.

Moreover, the median number of vascular endothelial growth factor injections in eyes remained stable over time, at 8 to 9 in nAMD, 6 to 7 in DMO, and 7 to 9 in RVO.

“A conscious effort to treat these conditions more intensively, or with longer lasting agents, would likely improve outcomes further in our patients,” the researchers said.

“Further research is warranted to evaluate whether long-term outcomes have also stabilised, noting that individualised treatment regimens tend to diverge after 12 months and long-term patient compliance remains a significant challenge in routine clinical practice,” they added.