How Have Intravitreal Anti-VEGF and Dexamethasone Implant Been Used in Italy? A Multiregional, Population-Based Study in the Years 2010-2016

Giulia Scondotto, Janet Sultana, Valentina Ientile, Ylenia Ingrasciotta, Andrea Fontana, Massimiliano Copetti, Eliana Mirabelli, Costantino J. Trombetta, Carlo Rapisarda, Michele Reibaldi, Teresio Avitabile, Antonio Longo, Patricia Ibanez Toro, Maria Vadalà, Salvatore Cillino, Gianni Virgili, Rosa Gini, Olivia Leoni, Sebastiano Walter Pollina Addario, Pasquale CananziClaudia La Cavera, Maria Rosalia Puzo, Giovambattista De Sarro, Adele De Francesco, Gianluca Trifirò*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Purpose. To describe intravitreal anti-VEGF drug and dexamethasone use in four Italian regions. Methods. Four regional claims databases were used to measure drug prevalence, compare dosing intervals to those recommended in the summary of product characteristics (SPC), and identify switchers. Bilateral treatment and diabetic macular edema (DME) coding algorithms were validated, linking claims with a sample of prospectively collected ophthalmological data. Results. Overall, 41,836 patients received ≥1 study drug in 2010-2016 (4.8 per 10,000 persons). In 2016, anti-VEGF drug use ranged from 0.8 (Basilicata) to 5.7 (Lombardy) per 10,000 persons while intravitreal dexamethasone use ranged from 0.2 (Basilicata) to 1.4 (Lombardy) per 10,000 persons. Overall, 40,815 persons were incident users of study drugs. Among incident users with ≥1 year of follow-up (N = 30,745), 16.0% (N = 4,890) had only one pharmacy claim, especially for ranibizumab (60.9%). Switching occurred in 8.0% of users with ≥2 pharmacy claims (N = 33,637). The algorithms had an accuracy of 83.8 (95% CI: 79.7-87.3) concerning bilateral treatment and 72.3% (95% CI: 67.5-76.8) for DME. Conclusion. Study drug use increased over time in Lombardy, Basilicata, Calabria, and Sicily, despite a large heterogeneity in prevalence of use across regions. Drug treatment appeared to be partly in line with SPC, suggesting that improvement in clinical practice may be needed to maximize drug benefits.

Original languageEnglish
Article number7582763
Number of pages9
JournalBioMed Research International
Volume2020
DOIs
Publication statusPublished - 11 Jan 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Giulia Scondotto et al.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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