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Title: A real-world study of effectiveness of intravitreal bevacizumab and ranibizumab injection for treating retinal diseases in Thailand
Authors: Suthasinee Kumluang
Lily Ingsrisawang
Sermsiri Sangroongruangsri
Usa Chaikledkaew
Tanapat Ratanapakorn
Paisan Ruamviboonsuk
Wongsiri Taweebanjongsin
Janejit Choovuthayakorn
Somanus Thoongsuwan
Prut Hanutsaha
Kittisak Kulvichit
Thitiporn Ratanapojnard
Warapat Wongsawad
Pattara Leelahavarong
Yot Teerawattananon
Chulalongkorn University
Faculty of Medicine, Khon Kaen University
Kasetsart University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Thailand Ministry of Public Health
Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Phramongkutklao College of Medicine
Rajavithi Hospital
Chiang Mai University
Mettapracharak (Wat Rai Khing) Hospital
Keywords: Medicine
Issue Date: 29-Mar-2019
Citation: BMC Ophthalmology. Vol.19, No.1 (2019)
Abstract: © 2019 The Author(s). Background: To evaluate the effectiveness of intravitreal bevacizumab (IVB) and intravitreal ranibizumab (IVR) in actual practice for treating patients with retinal diseases in Thailand. Methods: A prospective, multi-centre, observational study was conducted among eight hospitals in their ophthalmology outpatient departments. Participants consisted of patients who had previously not received any IVB or IVR treatment between 2013 and 2014. The primary outcome measurement was the change in best-corrected visual acuity (BCVA) at the end of the follow-up period compared to baseline. Results: There were 1629 treatment-naïve patients for the pro re nata (PRN) treatment pattern and 226 treatment-naive patients for the three-injections (3Inj) treatment pattern. BCVA improvements were found in 35% of the PRN group and 47% of the 3Inj group; however, it was not clinically meaningful between the IVB and IVR groups (P-value = 0.568 for PRN, P-value = 0.103 for 3Inj). A multivariable logistic regression (using the propensity score) showed that positive factors associated with vision improvement for the PRN pattern were the number of drug injections, having retinal vein occlusion, and under 60 years of age, while good BCVA at baseline was a negative predictive factor. For the 3Inj pattern, under 60 years of age and baseline BCVA were statistically significant predictors. Nonetheless, diabetes mellitus (DM) without other comorbidities was a statistically significant predictor of low response to vision improvement compared to DM with other comorbidities. Conclusions: This study was the first observational, prospective study to evaluate the real-life effectiveness of IVB and IVR in Thailand. The majority of participants who used IVB or IVR showed improvements in BCVA after treatment. Further evaluation such as long-term follow-ups and subsequent comparison of effectiveness between IVB and IVR should be investigated due to the limited sample of IVR patients. Trial registration: Thai Clinical Trial Registry TCTR20141002001. Registered 02 October 2014 (retrospectively registered).
ISSN: 14712415
Appears in Collections:Scopus 2019

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