Healthcare Utilization and Treatment Patterns in Diabetic Macular Edema in Korea: a Retrospective Chart Review|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Background: Limited data exist on real-world treatment patterns for diabetic macular edema (DME) in Korea. In this study, we investigated DME treatment patterns from 2009 to 2014 and the impact of baseline treatment on healthcare resource utilization and visual acuity (VA) outcomes.
Methods: A retrospective cohort chart review of DME patients treated at 11 hospital ophthalmology clinics between January 1, 2012 and December 31, 2013 was conducted. We collected data on demographics, healthcare resource utilization (clinic visits, treatment visits, and visits for ocular investigations), distribution of DME treatments, and VA.
Results: Overall, 522 DME patients (men, 55.2%; mean age, 59 years; mean HbA1c [n = 209], 8.4%) with 842 DME eyes were evaluated. For all treatments, healthcare resource utilization was significantly higher during the first 6 months versus months 7–12, year 2, or year 3 (P ≤ 0.001), but was highest for patients whose first treatment was an anti-vascular endothelial growth factor (VEGF) treatment (visits/quarter; anti-VEGF, 1.9; corticosteroids, 1.7; laser, 1.4). Use of macular laser therapy decreased (44% to 8%), whereas use of anti-VEGF injections increased (44% to 69%) during the study period. However, VA improvement was not commensurate with healthcare resource utilization of anti-VEGF treatment (mean VA gain, 2.7 letters).
Conclusion: A trend toward increasing use of intravitreal anti-VEGF injections for DME treatment was observed in Korea. However, the frequency of dosing and monitoring was lower in clinical practice versus major clinical trials, which may have led to the less-than- favorable improvements in visual outcomes.

번역하기

참고문헌 (Reference)

1 김기영, "당뇨황반부종의 형태학적 분류에 따른 유리체강 내 라니비주맙 초기치료 후의 장기 임상결과" 대한안과학회 57 (57): 1604-1612, 2016

2 Jiang S, "Treatment patterns of anti-vascular endothelial growth factor and laser therapy among patients with diabetic macular edema" 21 (21): 735-741, 2015

3 Boyer DS, "Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema" 121 (121): 1904-1914, 2014

4 Mitchell P, "The RESTORE study : ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema" 118 (118): 615-625, 2011

5 김대중, "The Epidemiology of Diabetes in Korea" 대한당뇨병학회 35 (35): 303-308, 2011

6 Busch C, "Shall we stay, or shall we switch? Continued anti-VEGF therapy versus early switch to dexamethasone implant in refractory diabetic macular edema" 55 (55): 789-796, 2018

7 Massin P, "Safety and efficacy of ranibizumab in diabetic macular edema(RESOLVE Study) : a 12-month, randomized, controlled, double-masked, multicenter phase II study" 33 (33): 2399-2405, 2010

8 Shea AM, "Resource use and costs associated with diabetic macular edema in elderly persons" 126 (126): 1748-1754, 2008

9 Bressler SB, "Reproducibility of spectral-domain optical coherence tomography retinal thickness measurements and conversion to equivalent time-domain metrics in diabetic macular edema" 132 (132): 1113-1122, 2014

10 Bressler SB, "Reproducibility of Optovue RTVue optical coherence tomography retinal thickness measurements and conversion to equivalent Zeiss Stratus metrics in diabetic macular edema" 4 (4): 5-, 2015