Real-world visual acuity outcomes for patients with naïve neovascular age-related macular degeneration treated with aflibercept, ranibizumab, or bevacizumab in the Republic of Korea

• Published in: PloS one 2024-10, Vol.19 (10), p.e0310381
• Main Authors: Lee, Yeo Jin, Kang, Seungbum, Won, Jae Yon, Roh, Young Jung, Ra, Ho, Lee, Mee Yon, Park, Sung Pyo, Jee, Dong Hyun
• Format: Article
• Language: English
• Subjects: Acuity; Age; Age related diseases; Aged; Aged, 80 and over; Analysis; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - therapeutic use; Bevacizumab; Bevacizumab - administration & dosage; Bevacizumab - therapeutic use; Big Data; Biology and Life Sciences; Care and treatment; Chi-square test; Confounding (Statistics); Data collection; Drugs; Eye diseases; Female; Growth factors; Health services; Humans; Intravitreal Injections; Macular degeneration; Macular Degeneration - drug therapy; Male; Medicine and Health Sciences; Patient outcomes; Patients; People and places; Physiological aspects; Ranibizumab - administration & dosage; Ranibizumab - therapeutic use; Receptors, Vascular Endothelial Growth Factor - administration & dosage; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - administration & dosage; Recombinant Fusion Proteins - therapeutic use; Republic of Korea; Research and Analysis Methods; Retrospective Studies; Review boards; Social Sciences; Socioeconomic factors; Treatment Outcome; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual acuity; Visual Acuity - drug effects; Visual aspects
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0310381

To compare the visual outcomes of different anti-vascular endothelial growth factor (VEGF) drugs, including aflibercept, ranibizumab, and bevacizumab, in a real-world setting in Korea. We collected data from patients who received monotherapy using one of these three anti-VEGF drugs as naïve treatment after being diagnosed with neovascular age-related macular degeneration. The number of injections and visual acuity (VA) outcomes of each cohort were obtained and pairwise comparisons were performed using propensity score matching. A total of 254 aflibercept, 238 ranibizumab, and 282 bevacizumab treatment-naïve eyes were included. The mean VA change at 3 years for all cohorts combined was -1.8 letters, and the mean number of injections was 9.4. In the direct comparison of the three drugs, the mean change in the VA letter score was +2.0 letters for aflibercept and -11.7 letters for bevacizumab (P < 0.001). The number of aflibercept injections was significantly higher than the number of bevacizumab injections (P = 0.002). The visual outcomes for aflibercept and ranibizumab were +4.7 letters and -1.9 letters, respectively, and comparable results were obtained (P = 0.13). The VA outcomes for ranibizumab and bevacizumab were also not significantly different (P = 0.09). The numbers of injections for aflibercept, ranibizumab, and bevacizumab were 10.8, 6.7, and 8.8, respectively. Significant differences were observed between the injection frequencies comparisons of aflibercept and ranibizumab and ranibizumab and bevacizumab (P < 0.001 and P = 0.002, respectively). In the Korean clinical medical environment, which included various confounding factors, especially socioeconomic ones, the aflibercept VA outcome was significantly better than that of bevacizumab, and aflibercept injections were the most numerous. These real-world data imply that the drug effect as well as the environment in which the drug can be sufficiently used affected patient final VA scores.