IRIS Registry: One-third of patients with DME discontinue anti-VEGF treatment
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DENVER — About one-third of patients with diabetic macular edema discontinue anti-VEGF therapy in any given year and do not resume it, according to data from the IRIS Registry.
A retrospective analysis evaluated real-world anti-VEGF use among patients with DME.
“[The IRIS Registry] is one of the largest electronic health records in the world,” David Tabano, PhD, told Healio/OSN at the Association for Research in Vision and Ophthalmology meeting. “This is a fantastic representation of the patient population in the United States that are afflicted with DME and what their treatment looks like.”
Tabano and colleagues analyzed data from 190,345 eyes to explore long-term treatment patterns, including anti-VEGF use, agent type, drug switches and discontinuations. They stratified the results by baseline visual acuity and initial anti-VEGF agent.
Over a mean follow-up of 2.3 years, 77% of eyes received only one kind of anti-VEGF agent, with the most common being bevacizumab (52.9%). During the study, 15% of eyes switched agents after a mean of 53 weeks, including 74% of eyes that switched from bevacizumab to on-label ranibizumab or aflibercept.
Fifty-two percent of eyes discontinued treatment after a mean of 24 weeks. However, 33% of these eyes reinitiated treatment after a mean of 91 weeks.
Discontinuation without reinitiation was most common in patients with a baseline visual acuity of 20/200 or less.
“We see that discontinuation is pretty uniform across the years,” Tabano said. “Every year in follow-up, we see about a third of patients stop therapy and don’t come back. The real outstanding questions are, why are patients discontinuing, why are they switching and what can we do to keep them on therapy longer to maintain the visual gains that they get from their therapy?”
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Kim E, et al. Discontinuation, switching, and other long-term routine clinical practice treatment patterns among patients with diabetic macular edema initiating anti-VEGF: 6-year follow-up using the IRIS Registry. Presented at: Association for Research in Vision and Ophthalmology meeting; May 1-4, 2022; Denver.
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