000144844 001__ 144844 000144844 005__ 20250923084418.0 000144844 0247_ $$2doi$$a10.1007/s40123-024-00983-2 000144844 0248_ $$2sideral$$a139692 000144844 037__ $$aART-2024-139692 000144844 041__ $$aeng 000144844 100__ $$aDebourdeau, Eloi 000144844 245__ $$aTreat-and-Extend Versus Pro re nata Regimens of Ranibizumab and Aflibercept in Neovascular Age-Related Macular Degeneration: A Comparative Study from Routine Clinical Practice 000144844 260__ $$c2024 000144844 5060_ $$aAccess copy available to the general public$$fUnrestricted 000144844 5203_ $$aIntroduction Anti-vascular endothelial growth factor (VEGF) is generally given using pro re nata or “treat-and-extend” (T&E) regimens for neovascular age-related macular degeneration (nAMD). Randomized clinical trials have reported that T&E is superior to Pro re nata (PRN), but results from clinical trials may not always be replicated in clinical practice. Real-world data comparing T&E and PRN regimens for nAMD are limited. The objective of this work was to report 24-month outcomes of PRN versus T&E regimens for ranibizumab and aflibercept to treat nAMD in routine clinical practice. Methods We conducted a retrospective analysis of data from a prospectively designed observational outcomes registry, the Fight Retinal Blindness! Project (FRB). Treatment-naïve eyes starting nAMD treatment with at least three injections using a T&E or PRN regimen were tracked by using the FRB. The primary outcome was the mean change in visual acuity (VA) measured by the number of letters read on a logarithm of the minimum angle of resolution chart at 2 years versus baseline. The secondary outcome was the number of injections at 2 years. Results From January 1, 2015 to January 31, 2019, 3313 eyes from 2948 patients with nAMD were included: 1243 eyes from 1065 patients were classified as PRN and 2070 eyes from 1935 patients started a T&E regimen. At 24 months, patients on the T&E regimen experienced significantly greater mean (95% confidence interval) improvement in VA than those on PRN (+ 4.2 [3.1, 5.2] vs. + 1.3 [0.1, 2.6] letters; p < 0.001), with more injections (14.9 standard deviation(SD) 4.3) vs. 9.8(SD 4.3); p < 0.001). Conclusions Eyes treated with a T&E regimen had better VA outcomes from VEGF inhibitors than eyes treated PRN. This large real-world data assessment supports previous data from randomized clinical trials that the T&E regimen delivers better outcomes than PRN. Plain Language Summary This study focused on comparing two methods of treating neovascular age-related macular degeneration, a common eye condition. The treatments used were ranibizumab and aflibercept. We looked at the reactive “pro re nata” method, where treatment is given sporadically and only when the condition reactivates, and the proactive “treat-and-extend” method, which aims to keep the disease inactive with the fewest treatments at regular intervals. The main aim was to determine which method provides the best vision outcomes over a 24-month period and the frequency of treatment required. We found that the treat-and-extend method resulted in a greater improvement in vision than the pro re nata method, although it did require more injections. This study highlights the effectiveness of the treat-and-extend method for neovascular age-related macular degeneration, suggesting it gets better outcomes despite requiring more injections. 000144844 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttp://creativecommons.org/licenses/by-nc/3.0/es/ 000144844 590__ $$a3.2$$b2024 000144844 592__ $$a1.187$$b2024 000144844 591__ $$aOPHTHALMOLOGY$$b17 / 98 = 0.173$$c2024$$dQ1$$eT1 000144844 593__ $$aOphthalmology$$c2024$$dQ1 000144844 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000144844 700__ $$aBeylerian, Helene 000144844 700__ $$aNguyen, Vuong 000144844 700__ $$aBarthelmes, Daniel 000144844 700__ $$aGillies, Mark 000144844 700__ $$aGabrielle, Pierre Henry 000144844 700__ $$aVujosevic, Stela 000144844 700__ $$aOtoole, Louise 000144844 700__ $$aPuzo, Martin 000144844 700__ $$aCreuzot-Garcher, Catherine 000144844 700__ $$aWolff, Benjamin 000144844 700__ $$aDaien, Vincent 000144844 700__ $$aCohn, A. 000144844 700__ $$aMarsh, Bacchus 000144844 700__ $$aJaross, N. 000144844 700__ $$aBarry, R. 000144844 700__ $$aMcLean, I. 000144844 700__ $$aGuillaumie, T. 000144844 700__ $$aMiri, A. 000144844 700__ $$aGabrielle, P. 000144844 700__ $$aTick, S. 000144844 700__ $$aField, A. 000144844 700__ $$aWickremasinghe, S. 000144844 700__ $$aDayajeewa, C. 000144844 700__ $$aWells, J. 000144844 700__ $$aDunlop, A. 000144844 700__ $$aYoung, S. 000144844 700__ $$aMimoun, G. 000144844 700__ $$aGuymer, R. 000144844 700__ $$aCarnota, P. 000144844 700__ $$aGallego-Pinazo, R. 000144844 700__ $$aLayana, A. García 000144844 700__ $$aSaenz-de-Viteri, M. 000144844 700__ $$aFerrier, R. 000144844 700__ $$aChow, L. 000144844 700__ $$aSteiner, H. 000144844 700__ $$aAmini, A. 000144844 700__ $$aChen, J. 000144844 700__ $$aSaha, N. 000144844 700__ $$aWindle, P. 000144844 700__ $$aGillies, M. 000144844 700__ $$aHunt, A. 000144844 700__ $$aBeaumont, P. 000144844 700__ $$aLouw, Z. 000144844 700__ $$aLuckie, A. 000144844 700__ $$aLake, S. 000144844 700__ $$aQatarneh, D. 000144844 700__ $$aSararols, L. 000144844 700__ $$aSuarez, J. 000144844 700__ $$aBerdoukas, P. 000144844 700__ $$aViola, F. 000144844 700__ $$aMilner, R. Montejano 000144844 700__ $$aArruabarrena, C. 000144844 700__ $$aAscaso, F. 000144844 700__ $$aMurillo, A. Boned 000144844 700__ $$aDíaz, M. 000144844 700__ $$aRivases, G. Perez 000144844 700__ $$aCastiella, S. Alforja 000144844 700__ $$aCasaroli-Marano, R. 000144844 700__ $$aFigueras-Roca, M. 000144844 700__ $$aZarranz-Ventura, J. 000144844 700__ $$aMoreno, S. Gismero 000144844 700__ $$aEscobar, A. González 000144844 700__ $$aGutiérrez, JMoreno 000144844 700__ $$aEscobar, J. 000144844 700__ $$aLavid, F. 000144844 700__ $$aMuñoz, P. Catalán 000144844 700__ $$aSempere, M. Tena 000144844 700__ $$aRicci, F. 000144844 700__ $$aIturralde, L. Broc 000144844 700__ $$aSánchez, S. Gómez 000144844 700__ $$aGaray-Aramburu, G. 000144844 700__ $$aSanz, N. Munoz 000144844 700__ $$aCalvo, P. 000144844 700__ $$aSanchez, J. 000144844 700__ $$aAlonso, E. Almazan 000144844 700__ $$aZamora, M. Garcia 000144844 700__ $$aCiancas, E. 000144844 700__ $$aGonzalez-Lopez, J. 000144844 700__ $$aLorenzo, D. 000144844 700__ $$aAcebes, M. 000144844 700__ $$aAparicio-Sanchis, S. 000144844 700__ $$aHortelano, A. Fernández 000144844 700__ $$aSánchez, A. Piñero 000144844 700__ $$aGarcía García, L. 000144844 700__ $$aMartínez, E. Salinas 000144844 700__ $$aGesto, A. Campo 000144844 700__ $$aNúñez, M. Rodriguez 000144844 700__ $$aManning, L. 000144844 700__ $$aInvernizzi, A. 000144844 700__ $$aCastelnovo, L. 000144844 700__ $$aMichel, G. 000144844 700__ $$aWolff, B. 000144844 700__ $$aPerks, M. 000144844 700__ $$aArnold, J. 000144844 700__ $$aCass, H. 000144844 700__ $$aOToole, L. 000144844 700__ $$aTang, K. 000144844 700__ $$aChung, C. 000144844 700__ $$aDaien, V. 000144844 700__ $$aBanerjee, G. 000144844 700__ $$aMorgan, M. 000144844 700__ $$aGame, J. 000144844 700__ $$aThompson, C. 000144844 700__ $$aChalasani, R. 000144844 700__ $$aChilov, M. 000144844 700__ $$aFung, A. 000144844 700__ $$aNothling, S. 000144844 700__ $$aChong, R. 000144844 700__ $$aFraser-Bell, S. 000144844 700__ $$aYounan, C. 000144844 700__ $$aLouis, D. 000144844 700__ $$aLockie, P. 000144844 700__ $$aWong, J. 000144844 700__ $$aHinchcliffe, P. 000144844 700__ $$aBarthelmes, D. 000144844 700__ $$aDe Durana Santa Coloma, E. Diaz 000144844 700__ $$aGaray-Aramburu, G. 000144844 700__ $$aVujosevic, S. 000144844 700__ $$aMorros, H. Brosa 000144844 700__ $$aHarper, A. 000144844 700__ $$aODay, J. 000144844 700__ $$aHooper, C. 000144844 700__ $$aCid, Maria Jose Rodríguez 000144844 773__ $$g13, 9 (2024), 2343-2355$$tOphthalmology and Therapy$$x2193-8245 000144844 8564_ $$s694590$$uhttps://zaguan.unizar.es/record/144844/files/texto_completo.pdf$$yVersión publicada 000144844 8564_ $$s1953187$$uhttps://zaguan.unizar.es/record/144844/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000144844 909CO $$ooai:zaguan.unizar.es:144844$$particulos$$pdriver 000144844 951__ $$a2025-09-22-14:33:57 000144844 980__ $$aARTICLE