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IRIS Registry provides largest specialty clinical database for research
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NEW ORLEANS — The American Academy of Ophthalmology’s IRIS Registry, the world’s largest specialty clinical database, continues to provide aggregate, de-identified data for analytics, scientific inquiries and research, according to speakers at a press briefing.
“We are the world’s largest registry and world’s largest clinical database. We have 13,000 contracted physicians for 2017 in 5,119 practices. It’s about 70% of practicing ophthalmologists,” William L. Rich III, MD, FACS, said at a press briefing preceding the AAO meeting.
Using data from the IRIS Registry, Mathew W. MacCumber, MD, PhD, and colleagues analyzed the impact of anti-VEGF injections on IOP in more than 23,000 patients; 5,879 patients received Lucentis (ranibizumab, Genentech) injections, 4,548 received Eylea (aflibercept, Regeneron) injections, and 13,349 received Avastin (bevacizumab, Genentech) injections.
The study concluded that bevacizumab and aflibercept intravitreous injections are associated with a small but statistically significant decrease in IOP over time when compared with untreated eyes. Also, a sustained “clinically significant IOP elevation” was observed for bevacizumab and ranibizumab in a small percentage of eyes but not for aflibercept, MacCumber said.
“We found a 2.8% rise for ranibizumab and bevacizumab vs. the control of about 1.5% and really no change for aflibercept," he said.
Jeffrey R. Willis, MD, PhD, and colleagues used the IRIS Registry to analyze treatment patterns for diabetic macular edema in the United States. The retrospective cohort study included 13,410 newly diagnosed, treatment-naïve cases of DME. Using data from the registry, Willis noted 75% of patients in the study likely did not receive any treatment within 28 days of their diagnosis and 60% had likely received no treatment after a year of follow-up.
The most common treatment for those in the cohort was anti-VEGF injections, but almost half who received an anti-VEGF agent received three or fewer injections during the 1-year follow-up period, he said.
“When we analyzed the data, we found DME patients are likely undertreated in a real-world setting. Even when they receive anti-VEGF, they’re likely getting a suboptimal number of injections. It characterizes that there are several barriers to optimal treatment in the U.S., and future research should focus on what these barriers are and developing interventions to provide increased access to patients newly diagnosed with DME,” Willis said.
Joshua D. Stein, MD, MS, and colleagues used the registry to study patients with glaucoma and found the registry simplified their ability to track a multitude of clinical variables used to characterize glaucoma.
To further the use of the IRIS Registry and to train researchers on how to properly use the program, Brian F. Hofland, PhD, president of Research to Prevent Blindness (RPB), and Rich announced a partnership between AAO and RPB to provide $35,000 grants to fund six studies over 2 years. Recipients will visit the AAO office in San Francisco to learn about IRIS Registry data. – by Robert Linnehan
Disclosures: MacCumber reports he receives grant support from Aerpio, Alimera Sciences, Allergan, Clearside Biomedical, Genentech, National Eye Institute, Regeneron and ThromboGenics; is a consultant with Alimera Sciences, Genentech, Regeneron and ThromboGenics; and is an equity owner with Covalent Medical and U.S. Retina. Willis reports he is an employee with Genentech. Hofland, Rich and Stein report no relevant financial disclosures.