Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration

Individualized treatment regimens may reduce patient burden with satisfactory patient outcomes in neovascular age-related macular degeneration. Intravitreal anti-VEGF drugs are the current gold standard. Fixed monthly injections offer the best visual outcome but this regimen is not commonly followed...

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Main Authors: Alfredo García-Layana, Marta S. Figueroa, Luis Arias, Javier Araiz, José María Ruiz-Moreno, José García-Arumí, Francisco Gómez-Ulla, María Isabel López-Gálvez, Francisco Cabrera-López, José Manuel García-Campos, Jordi Monés, Enrique Cervera, Felix Armadá, Roberto Gallego-Pinazo
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2015/412903
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author Alfredo García-Layana
Marta S. Figueroa
Luis Arias
Javier Araiz
José María Ruiz-Moreno
José García-Arumí
Francisco Gómez-Ulla
María Isabel López-Gálvez
Francisco Cabrera-López
José Manuel García-Campos
Jordi Monés
Enrique Cervera
Felix Armadá
Roberto Gallego-Pinazo
author_facet Alfredo García-Layana
Marta S. Figueroa
Luis Arias
Javier Araiz
José María Ruiz-Moreno
José García-Arumí
Francisco Gómez-Ulla
María Isabel López-Gálvez
Francisco Cabrera-López
José Manuel García-Campos
Jordi Monés
Enrique Cervera
Felix Armadá
Roberto Gallego-Pinazo
author_sort Alfredo García-Layana
collection DOAJ
description Individualized treatment regimens may reduce patient burden with satisfactory patient outcomes in neovascular age-related macular degeneration. Intravitreal anti-VEGF drugs are the current gold standard. Fixed monthly injections offer the best visual outcome but this regimen is not commonly followed outside clinical trials. A PRN regimen requires monthly visits where the patient is treated in the presence of signs of lesion activity. Therefore, an early detection of reactivation of the disease with immediate retreatment is crucial to prevent visual acuity loss. Several trials suggest that “treat and extend” and other proactive regimens provide a reasonable approach. The rationale of the proactive regimens is to perform treatment anticipating relapses or recurrences and therefore avoid drops in vision while individualizing patient followup. Treat and extend study results in significant direct medical cost savings from fewer treatments and office visits compared to monthly treatment. Current data suggest that, for one year, PRN is less expensive, but treat and extend regimen would likely be less expensive for subsequent years. Once a patient is not a candidate to continue with treatment, he/she should be sent to an outpatient unit with adequate resources to follow nAMD patients in order to reduce the burden of specialized ophthalmologist services.
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spelling doaj-art-df4c754bab5a4152866b9d95b06547032025-08-20T03:26:21ZengWileyJournal of Ophthalmology2090-004X2090-00582015-01-01201510.1155/2015/412903412903Individualized Therapy with Ranibizumab in Wet Age-Related Macular DegenerationAlfredo García-Layana0Marta S. Figueroa1Luis Arias2Javier Araiz3José María Ruiz-Moreno4José García-Arumí5Francisco Gómez-Ulla6María Isabel López-Gálvez7Francisco Cabrera-López8José Manuel García-Campos9Jordi Monés10Enrique Cervera11Felix Armadá12Roberto Gallego-Pinazo13Clínica Universidad de Navarra, Avenida de Pío XII 36, 31008 Pamplona, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainSociedad Española de Retina y Vítreo (SERV), C/ Xosé Chao Rego 8, 15705 Santiago de Compostela, SpainIndividualized treatment regimens may reduce patient burden with satisfactory patient outcomes in neovascular age-related macular degeneration. Intravitreal anti-VEGF drugs are the current gold standard. Fixed monthly injections offer the best visual outcome but this regimen is not commonly followed outside clinical trials. A PRN regimen requires monthly visits where the patient is treated in the presence of signs of lesion activity. Therefore, an early detection of reactivation of the disease with immediate retreatment is crucial to prevent visual acuity loss. Several trials suggest that “treat and extend” and other proactive regimens provide a reasonable approach. The rationale of the proactive regimens is to perform treatment anticipating relapses or recurrences and therefore avoid drops in vision while individualizing patient followup. Treat and extend study results in significant direct medical cost savings from fewer treatments and office visits compared to monthly treatment. Current data suggest that, for one year, PRN is less expensive, but treat and extend regimen would likely be less expensive for subsequent years. Once a patient is not a candidate to continue with treatment, he/she should be sent to an outpatient unit with adequate resources to follow nAMD patients in order to reduce the burden of specialized ophthalmologist services.http://dx.doi.org/10.1155/2015/412903
spellingShingle Alfredo García-Layana
Marta S. Figueroa
Luis Arias
Javier Araiz
José María Ruiz-Moreno
José García-Arumí
Francisco Gómez-Ulla
María Isabel López-Gálvez
Francisco Cabrera-López
José Manuel García-Campos
Jordi Monés
Enrique Cervera
Felix Armadá
Roberto Gallego-Pinazo
Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration
Journal of Ophthalmology
title Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration
title_full Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration
title_fullStr Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration
title_full_unstemmed Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration
title_short Individualized Therapy with Ranibizumab in Wet Age-Related Macular Degeneration
title_sort individualized therapy with ranibizumab in wet age related macular degeneration
url http://dx.doi.org/10.1155/2015/412903
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