Undertreatment of Neovascular Age-Related Macular Degeneration after 10 Years of Anti-Vascular Endothelial Growth Factor Therapy in the Real World: The Need for A Change of Mindset
To assess the gap between visual acuity (VA) outcomes with anti-vascular endothelial growth factor (anti-VEGF) therapies in clinical trials and real-world practice, and explore the reasons for this gap. The literature was searched from January 1, 2013, to June 30, 2018, for studies reporting VA gain...
Uloženo v:
| Vydáno v: | Ophthalmologica (Basel) Ročník 243; číslo 1; s. 1 |
|---|---|
| Hlavní autoři: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Switzerland
2020
|
| Témata: | |
| ISSN: | 1423-0267, 1423-0267 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | To assess the gap between visual acuity (VA) outcomes with anti-vascular endothelial growth factor (anti-VEGF) therapies in clinical trials and real-world practice, and explore the reasons for this gap.
The literature was searched from January 1, 2013, to June 30, 2018, for studies reporting VA gains and injection frequencies in clinical trials and real-world practice.
Clinical trials of anti-VEGF agents and their extension studies demonstrated initial VA gains maintained at 4 years and beyond (up to 7 years) with continuous proactive treatment. Visual outcomes correlated with injection frequency. In real-world practice, patients are usually undertreated, accounting for the VA decline over time. Reasons for undertreatment include the burden of injections and monitoring visits imposed on patients/caregivers. However, another primary reason is the general mindset in the ophthalmological community that sustained benefits with treatment are not possible, leading to poor compliance and creating a vicious circle.
Initial VA gains can be maintained with more intensive/proactive approaches. Promising new treatments requiring less frequent injections/monitoring will help in the near future; meanwhile, better results could be achieved by changing the community mindset that contributes to undertreatment. |
|---|---|
| AbstractList | To assess the gap between visual acuity (VA) outcomes with anti-vascular endothelial growth factor (anti-VEGF) therapies in clinical trials and real-world practice, and explore the reasons for this gap.
The literature was searched from January 1, 2013, to June 30, 2018, for studies reporting VA gains and injection frequencies in clinical trials and real-world practice.
Clinical trials of anti-VEGF agents and their extension studies demonstrated initial VA gains maintained at 4 years and beyond (up to 7 years) with continuous proactive treatment. Visual outcomes correlated with injection frequency. In real-world practice, patients are usually undertreated, accounting for the VA decline over time. Reasons for undertreatment include the burden of injections and monitoring visits imposed on patients/caregivers. However, another primary reason is the general mindset in the ophthalmological community that sustained benefits with treatment are not possible, leading to poor compliance and creating a vicious circle.
Initial VA gains can be maintained with more intensive/proactive approaches. Promising new treatments requiring less frequent injections/monitoring will help in the near future; meanwhile, better results could be achieved by changing the community mindset that contributes to undertreatment. To assess the gap between visual acuity (VA) outcomes with anti-vascular endothelial growth factor (anti-VEGF) therapies in clinical trials and real-world practice, and explore the reasons for this gap.PURPOSETo assess the gap between visual acuity (VA) outcomes with anti-vascular endothelial growth factor (anti-VEGF) therapies in clinical trials and real-world practice, and explore the reasons for this gap.The literature was searched from January 1, 2013, to June 30, 2018, for studies reporting VA gains and injection frequencies in clinical trials and real-world practice.METHODSThe literature was searched from January 1, 2013, to June 30, 2018, for studies reporting VA gains and injection frequencies in clinical trials and real-world practice.Clinical trials of anti-VEGF agents and their extension studies demonstrated initial VA gains maintained at 4 years and beyond (up to 7 years) with continuous proactive treatment. Visual outcomes correlated with injection frequency. In real-world practice, patients are usually undertreated, accounting for the VA decline over time. Reasons for undertreatment include the burden of injections and monitoring visits imposed on patients/caregivers. However, another primary reason is the general mindset in the ophthalmological community that sustained benefits with treatment are not possible, leading to poor compliance and creating a vicious circle.RESULTSClinical trials of anti-VEGF agents and their extension studies demonstrated initial VA gains maintained at 4 years and beyond (up to 7 years) with continuous proactive treatment. Visual outcomes correlated with injection frequency. In real-world practice, patients are usually undertreated, accounting for the VA decline over time. Reasons for undertreatment include the burden of injections and monitoring visits imposed on patients/caregivers. However, another primary reason is the general mindset in the ophthalmological community that sustained benefits with treatment are not possible, leading to poor compliance and creating a vicious circle.Initial VA gains can be maintained with more intensive/proactive approaches. Promising new treatments requiring less frequent injections/monitoring will help in the near future; meanwhile, better results could be achieved by changing the community mindset that contributes to undertreatment.CONCLUSIONSInitial VA gains can be maintained with more intensive/proactive approaches. Promising new treatments requiring less frequent injections/monitoring will help in the near future; meanwhile, better results could be achieved by changing the community mindset that contributes to undertreatment. |
| Author | Bandello, Francesco Souied, Eric Monés, Jordi Gale, Richard Liu, Xin Singh, Rishi P |
| Author_xml | – sequence: 1 givenname: Jordi surname: Monés fullname: Monés, Jordi email: jmones@institutmacularetina.com organization: Institut de la Màcula and Barcelona Macula Foundation, Barcelona, Spain, jmones@institutmacularetina.com – sequence: 2 givenname: Rishi P surname: Singh fullname: Singh, Rishi P organization: Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA – sequence: 3 givenname: Francesco surname: Bandello fullname: Bandello, Francesco organization: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy – sequence: 4 givenname: Eric surname: Souied fullname: Souied, Eric organization: Department of Ophthalmology, Hopital Intercommunal de Creteil, Creteil, France – sequence: 5 givenname: Xin surname: Liu fullname: Liu, Xin organization: Novartis Pharma AG, Basel, Switzerland – sequence: 6 givenname: Richard surname: Gale fullname: Gale, Richard organization: York Teaching Hospitals, York, United Kingdom |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31743912$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkM1OwzAMgCME4v_AC6AcuRScn64rt2kwQNpAQhuI0-S2zlbUJSPJQLwXD0inDYlLbNmfP1s5YrvWWWLsTMClEGl-BQApyExnO-xQaKkSkJ1s919-wI5CeAdo4VzsswMlMq1yIQ_Zz8RW5KMnjAuykTvDH8l9YihXDXrem1HyTA1GqvgIN7UbmpElj7F2lqOJ5LkA_kbow3q8Z2OdvPwJbm3l4pyaGht-591XnPMBltF5Pp63juU3ry1vAf5MLfHqfFNdr1vtFe1K03I93p-jndHaPaptFSiesD2DTaDTbTxmk8HtuH-fDJ_uHvq9YVKqTh6T1JhO0YWuQqUhrVRVUEogQOepgUwUGrRIM10UqDLVLUmafP1CVxhdCEB5zC423qV3HysKcbqoQ0lNg5bcKkylEh2thMxVi55v0VWxoGq69PUC_ff076flL1PZgPY |
| CitedBy_id | crossref_primary_10_1007_s40123_022_00471_5 crossref_primary_10_1007_s00417_021_05543_z crossref_primary_10_2147_OPTH_S415044 crossref_primary_10_1007_s00417_023_06321_9 crossref_primary_10_1136_bmjophth_2022_001104 crossref_primary_10_1038_s41433_022_02153_9 crossref_primary_10_1111_ceo_14559 crossref_primary_10_4103_ijo_IJO_3066_21 crossref_primary_10_1016_j_jconrel_2023_06_034 crossref_primary_10_1111_ceo_13742 crossref_primary_10_3928_23258160_20210429_04 crossref_primary_10_1097_IAE_0000000000003699 crossref_primary_10_2147_OPTH_S275977 crossref_primary_10_1007_s12325_025_03319_z crossref_primary_10_3928_23258160_20231016_01 crossref_primary_10_1016_j_oret_2023_05_005 crossref_primary_10_1186_s12886_023_03034_9 crossref_primary_10_1007_s40123_025_01229_5 crossref_primary_10_1016_j_jcjo_2021_10_008 crossref_primary_10_2147_OPTH_S468617 crossref_primary_10_1177_11206721211001716 crossref_primary_10_1371_journal_pone_0272301 crossref_primary_10_1016_j_survophthal_2024_03_009 crossref_primary_10_1159_000507711 crossref_primary_10_1159_000539648 crossref_primary_10_1016_j_oftal_2022_02_006 crossref_primary_10_1038_s41433_022_01957_z crossref_primary_10_1038_s41433_024_03308_6 crossref_primary_10_1007_s40123_023_00757_2 crossref_primary_10_1007_s00417_025_06798_6 crossref_primary_10_1136_bmjopen_2021_049495 crossref_primary_10_1371_journal_pone_0304782 crossref_primary_10_1136_bjo_2024_325640 crossref_primary_10_3390_jcm13175208 crossref_primary_10_1007_s40123_024_01061_3 crossref_primary_10_1007_s00347_020_01273_5 crossref_primary_10_1111_aos_15005 crossref_primary_10_1016_S0140_6736_24_00687_1 crossref_primary_10_1038_s41598_025_09348_6 crossref_primary_10_1016_j_oftale_2022_05_006 crossref_primary_10_1186_s40942_021_00325_5 crossref_primary_10_2147_OPTH_S324600 crossref_primary_10_1038_s41598_022_18158_z crossref_primary_10_1111_aos_14905 crossref_primary_10_1016_j_biopha_2023_114368 crossref_primary_10_1038_s41433_025_03830_1 crossref_primary_10_1038_s41598_022_06362_w crossref_primary_10_1016_j_apjo_2024_100069 crossref_primary_10_1016_j_ajo_2022_06_005 crossref_primary_10_2147_OPTH_S391082 crossref_primary_10_2147_OPTH_S481772 crossref_primary_10_1159_000527345 crossref_primary_10_33393_dti_2022_2343 crossref_primary_10_3390_jcm13237033 crossref_primary_10_1097_IIO_0000000000000509 crossref_primary_10_1136_bjophthalmol_2021_319090 crossref_primary_10_1038_s41598_020_76354_1 crossref_primary_10_1038_s41433_023_02540_w crossref_primary_10_1186_s12348_023_00369_8 crossref_primary_10_1186_s12886_024_03387_9 crossref_primary_10_1136_bjophthalmol_2021_319054 crossref_primary_10_1016_j_survophthal_2020_08_005 crossref_primary_10_3390_ph14010050 crossref_primary_10_1055_a_1770_4037 crossref_primary_10_1159_000527815 crossref_primary_10_1007_s40123_023_00854_2 crossref_primary_10_1136_bmjopen_2021_055478 crossref_primary_10_3390_jcm13123434 crossref_primary_10_1007_s00347_020_01218_y crossref_primary_10_1038_s41433_024_03218_7 crossref_primary_10_1371_journal_pone_0256461 crossref_primary_10_1016_j_exer_2025_110258 crossref_primary_10_1111_aos_15224 crossref_primary_10_1016_j_ajo_2025_06_010 crossref_primary_10_1111_aos_16598 crossref_primary_10_1055_a_1778_4782 crossref_primary_10_1111_aos_17444 crossref_primary_10_3390_biomedicines11071910 |
| ContentType | Journal Article |
| Copyright | 2019 S. Karger AG, Basel. |
| Copyright_xml | – notice: 2019 S. Karger AG, Basel. |
| DBID | NPM 7X8 |
| DOI | 10.1159/000502747 |
| DatabaseName | PubMed MEDLINE - Academic |
| DatabaseTitle | PubMed MEDLINE - Academic |
| DatabaseTitleList | PubMed MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1423-0267 |
| ExternalDocumentID | 31743912 |
| Genre | Journal Article Review |
| GroupedDBID | --- .55 .GJ 0R~ 0~5 0~B 123 29N 30W 329 34G 39C 3O- 3O. 3V. 4.4 53G 5RE 7X7 88E 8AO 8FI 8FJ 8FW 8G5 8UI AALGM AAYIC ABBTS ABDBF ABJNI ABOCM ABPAZ ABUWG ABWCG ACGFS ACNCT ACPSR ACQXL ACUHS ADAGL ADBBV AENEX AEYAO AFFNX AFJJK AFKRA AFSIO AHFRZ AHMBA ALDHI ALIPV ALMA_UNASSIGNED_HOLDINGS AZPMC AZQEC BENPR BPHCQ BVXVI CAG CCPQU COF CS3 CYUIP DU5 DWQXO E0A EBS EJD FB. FYUFA GNUQQ GUQSH HMCUK HZ~ IY7 KUZGX L7B M1P M2O N9A NPM O1H O9- PQQKQ PROAC PSQYO RIG RKO RXVBD UJ6 UKHRP X7M ZGI ZXP 7X8 |
| ID | FETCH-LOGICAL-c369t-5ff6b8083a3405d3dbe5e010495f071b4041574bba3738ce2f98ce2081f4b10a2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 88 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000507909500001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1423-0267 |
| IngestDate | Wed Oct 01 14:02:17 EDT 2025 Wed Feb 19 02:32:13 EST 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 1 |
| Keywords | Anti-VEGF Undertreatment Neovascular age-related macular degeneration Treatment burden |
| Language | English |
| License | 2019 S. Karger AG, Basel. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c369t-5ff6b8083a3405d3dbe5e010495f071b4041574bba3738ce2f98ce2081f4b10a2 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
| OpenAccessLink | https://www.karger.com/Article/Pdf/502747 |
| PMID | 31743912 |
| PQID | 2316431293 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2316431293 pubmed_primary_31743912 |
| PublicationCentury | 2000 |
| PublicationDate | 2020-00-00 20200101 |
| PublicationDateYYYYMMDD | 2020-01-01 |
| PublicationDate_xml | – year: 2020 text: 2020-00-00 |
| PublicationDecade | 2020 |
| PublicationPlace | Switzerland |
| PublicationPlace_xml | – name: Switzerland |
| PublicationTitle | Ophthalmologica (Basel) |
| PublicationTitleAlternate | Ophthalmologica |
| PublicationYear | 2020 |
| SSID | ssj0015991 |
| Score | 2.5097086 |
| SecondaryResourceType | review_article |
| Snippet | To assess the gap between visual acuity (VA) outcomes with anti-vascular endothelial growth factor (anti-VEGF) therapies in clinical trials and real-world... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 1 |
| Title | Undertreatment of Neovascular Age-Related Macular Degeneration after 10 Years of Anti-Vascular Endothelial Growth Factor Therapy in the Real World: The Need for A Change of Mindset |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/31743912 https://www.proquest.com/docview/2316431293 |
| Volume | 243 |
| WOSCitedRecordID | wos000507909500001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT8MwDI6AIcSF92O8ZCSuEbTNHuGCJtjgsmlCgMZpShtnTELdoIVfxg_ETrtxQkLi0kPapJHsOJ9jx58QZ2R2tbZOSeuMksqZQGqLieTaY0Y3rQlj48kmGr1eczDQ_fLALSvTKmc20RtqO0n4jPyccAhtnrw7XU3fJLNGcXS1pNBYFJWIoAxrdWPwE0Woac-YFxBkkMy0VFYWonbPZec9st-Rpd9hOuv_nduGWCuxJbQKZdgUC5huiZVuGT3fFl-e5GieWg4TBz2c56JCa4TS58ahha4p2m5w5OtSs_jA84lDcAHPtDwy7t5K87F8mg3QTi3f53ollYZbcu_zF-h4Oh94KGoXwDgF-gDuCZ2CT-O55Fc0C_oloWdoQXHbgcfujlObYb4jHjvth-s7WbI2yCSq61zWnKvHTUJ2JiIwaCMbYw3Z69M1R3gmVlwUoKHi2HBRpQRDp_lJ0MSpOLgw4a5YSicp7guIQuRRlFaGUIhFo9DGCRIIazTrJtFVcTqTx5BWBYc6TIqTj2z4I5Gq2CuEOpwW5TuGkXfCgvDgD70PxWrIDrY_czkSFUc2AY_FcvKZj7P3E69u9Oz1u9-PNeFg |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Undertreatment+of+Neovascular+Age-Related+Macular+Degeneration+after+10+Years+of+Anti-Vascular+Endothelial+Growth+Factor+Therapy+in+the+Real+World%3A+The+Need+for+A+Change+of+Mindset&rft.jtitle=Ophthalmologica+%28Basel%29&rft.au=Mon%C3%A9s%2C+Jordi&rft.au=Singh%2C+Rishi+P&rft.au=Bandello%2C+Francesco&rft.au=Souied%2C+Eric&rft.date=2020-01-01&rft.issn=1423-0267&rft.eissn=1423-0267&rft.volume=243&rft.issue=1&rft.spage=1&rft_id=info:doi/10.1159%2F000502747&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1423-0267&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1423-0267&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1423-0267&client=summon |