Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF
Abstract Introduction To evaluate long-term outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) in the Netherlands (NL), where bevacizumab is the mandated first-line drug, compared to high-income countries using ranibizumab or aflibercept as initial treatments. Meth...
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Adis, Springer Healthcare
2025-06-01
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| Series: | Ophthalmology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40123-025-01178-z |
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| author | H. Mhmud J. P. Vermeulen O. A. M. Tigchelaar-Besling F. D. Verbraak D. Barthelmes M. Gillies T. L. Ponsioen Caroline C. W. Klaver |
| author_facet | H. Mhmud J. P. Vermeulen O. A. M. Tigchelaar-Besling F. D. Verbraak D. Barthelmes M. Gillies T. L. Ponsioen Caroline C. W. Klaver |
| author_sort | H. Mhmud |
| collection | DOAJ |
| description | Abstract Introduction To evaluate long-term outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) in the Netherlands (NL), where bevacizumab is the mandated first-line drug, compared to high-income countries using ranibizumab or aflibercept as initial treatments. Methods Five-year data from the Fight Retinal Blindness! (FRB) registry, a real-world prospective registry, were analyzed. Outcomes from 1473 Dutch eyes (1229 patients) treated with bevacizumab were compared with 7144 eyes (5884 patients) in a reference group (RG) from 13 socioeconomically similar countries. The primary outcome was mean visual acuity (VA) at yearly intervals; secondary outcomes included injection frequency and switching rates to alternative anti-VEGF agents. Results Throughout the 60 months, mean VA was consistently higher in Dutch eyes (baseline: NL 60.2 vs. RG 59.2; 60 months: NL 64.9 vs. RG 62.6). The Dutch group cumulatively received 14.5 more injections over 5 years and had a higher rate of switching (70.9% vs. 50.9%) with a shorter median time to switching (11.9 months vs. 17.7 months). Conclusions Patients treated in Dutch FRB! clinics have good long-term outcomes with a 2.3-letter higher mean VA at the 60-month timepoint compared to FRB! clinics in the RG. The Dutch patients, who began treatment with bevacizumab, received 14.5 more injections over 5 years and had a 40% higher rate of switching to an alternative drug, with switching occurring 5.8 months earlier. This study highlights the benefits of early and more intensive management to optimize visual outcomes, which appear more important than the choice and price of the first-line drug. |
| format | Article |
| id | doaj-art-587542fa8e6742f3a4c2a47ab68ad5ea |
| institution | Kabale University |
| issn | 2193-8245 2193-6528 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Ophthalmology and Therapy |
| spelling | doaj-art-587542fa8e6742f3a4c2a47ab68ad5ea2025-08-20T03:46:03ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-06-011481813182610.1007/s40123-025-01178-zReal-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGFH. Mhmud0J. P. Vermeulen1O. A. M. Tigchelaar-Besling2F. D. Verbraak3D. Barthelmes4M. Gillies5T. L. Ponsioen6Caroline C. W. Klaver7Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterDepartment of Ophthalmology, Erasmus Medical CenterDepartment of Ophthalmology, Amphia HospitalDepartment of Ophthalmology, Amsterdam University Medical CenterDepartment of Ophthalmology, University Hospital Zurich and University of ZurichSave Sight Institute, University of SydneyDepartment of Ophthalmology, Isala HospitalDepartment of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterAbstract Introduction To evaluate long-term outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (nAMD) in the Netherlands (NL), where bevacizumab is the mandated first-line drug, compared to high-income countries using ranibizumab or aflibercept as initial treatments. Methods Five-year data from the Fight Retinal Blindness! (FRB) registry, a real-world prospective registry, were analyzed. Outcomes from 1473 Dutch eyes (1229 patients) treated with bevacizumab were compared with 7144 eyes (5884 patients) in a reference group (RG) from 13 socioeconomically similar countries. The primary outcome was mean visual acuity (VA) at yearly intervals; secondary outcomes included injection frequency and switching rates to alternative anti-VEGF agents. Results Throughout the 60 months, mean VA was consistently higher in Dutch eyes (baseline: NL 60.2 vs. RG 59.2; 60 months: NL 64.9 vs. RG 62.6). The Dutch group cumulatively received 14.5 more injections over 5 years and had a higher rate of switching (70.9% vs. 50.9%) with a shorter median time to switching (11.9 months vs. 17.7 months). Conclusions Patients treated in Dutch FRB! clinics have good long-term outcomes with a 2.3-letter higher mean VA at the 60-month timepoint compared to FRB! clinics in the RG. The Dutch patients, who began treatment with bevacizumab, received 14.5 more injections over 5 years and had a 40% higher rate of switching to an alternative drug, with switching occurring 5.8 months earlier. This study highlights the benefits of early and more intensive management to optimize visual outcomes, which appear more important than the choice and price of the first-line drug.https://doi.org/10.1007/s40123-025-01178-zAge-related macular degenerationNeovascular AMDBevacizumabAMD management |
| spellingShingle | H. Mhmud J. P. Vermeulen O. A. M. Tigchelaar-Besling F. D. Verbraak D. Barthelmes M. Gillies T. L. Ponsioen Caroline C. W. Klaver Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF Ophthalmology and Therapy Age-related macular degeneration Neovascular AMD Bevacizumab AMD management |
| title | Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF |
| title_full | Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF |
| title_fullStr | Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF |
| title_full_unstemmed | Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF |
| title_short | Real-World 5-Year Outcomes of Age-Related Macular Degeneration with Bevacizumab as First-Line Anti-VEGF |
| title_sort | real world 5 year outcomes of age related macular degeneration with bevacizumab as first line anti vegf |
| topic | Age-related macular degeneration Neovascular AMD Bevacizumab AMD management |
| url | https://doi.org/10.1007/s40123-025-01178-z |
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