Demographics of patients receiving Intravitreal anti-VEGF treatment in real-world practice: healthcare research data versus randomized controlled trials

Abstract Background While randomized controlled trials (RCTs) are based on strict inclusion/exclusion criteria, non-interventional studies (NISs) might provide additional information to guide management in patients more representative to the real-world setting. The aim of this study was to compare baseline characteristics of patients receiving intravitreal treatment in the NIS OCEAN with those from published RCTs. Methods The ongoing OCEAN study enrolled patients treated with ranibizumab for neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DME) or branch/central retinal vein occlusion (B/CRVO). Baseline patient characteristics were compared by indication within the OCEAN cohort. Furthermore, the characteristics were set in reference to those of published RCTs in the same indications. Confidence intervals (CIs) were calculated and assessed for statistically significant differences as indicated by non-overlapping CIs. Results Patient characteristics in the NIS OCEAN were evaluated for 3,614 patients with nAMD, 1,211 with DME, 204 with BRVO and 121 with CRVO. Between these groups, significant differences in mean age, gender distributions, and mean baseline VA were seen, reflecting known differences between the indications. Compared to the patient characteristics of published RCTs (trials selected by literature search: nAMD: 13 RCTs, DME: 9, RVO: 5), the OCEAN patientsâ mean age was significantly higher in every indication. The gender distributions across the trials were comparable, with only few differences between OCEAN and the RCTs. Regarding the mean baseline VA, notable differences were found in nAMD and in DME, with VA significantly higher in some RCTs and lower in others. Conclusions The described differences underline the complementarity of NISs and RCTs. OCEAN covers a broader spectrum and more variability of patients than do RCTs. As baseline values may have impact on the treatment response (ceiling effect), there is an ongoing need for research in all patient subgroups. Country-specific assessments of patient populations can better reflect the real-world situation. NISs can deliver insights that RCTs may not, as NISs can include non-typical patients, patients with comorbidities, a broader age spectrum and patients of various disease stages. Trial registration The NIS OCEAN was registered on www.clinicaltrials.gov (identifier: NCT02194803 ).

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PID https://www.doi.org/10.6084/m9.figshare.c.3669994
PID https://www.doi.org/10.6084/m9.figshare.c.3669994.v1
PID https://www.doi.org/10.15496/publikation-23067
URL http://dx.doi.org/10.6084/m9.figshare.c.3669994
URL http://dx.doi.org/10.15496/publikation-23067
URL http://dx.doi.org/10.6084/m9.figshare.c.3669994.v1
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Author F. Ziemssen
Author N. Feltgen
Author FG. Holz
Author R. Guthoff
Author A. Ringwald
Author T. Bertelmann
Author A. Wiedon
Author C. Korb
Contributor University, My
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Publication Date 2017-01-01
Publisher Figshare
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Language UNKNOWN
Resource Type Collection; Other ORP type
keyword FOS: Biological sciences
keyword FOS: Health sciences
system:type other
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Source https://science-innovation-policy.openaire.eu/search/other?orpId=dedup_wf_001::dc2af0e7b19d9cfa7b6d65d603d1dcdc
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Last Updated 19 December 2020, 13:55 (CET)
Created 19 December 2020, 13:55 (CET)