Impact of Delayed Time to Treatment on Visual Outcomes in Neovascular AMD: Data From the HARBOR Study

• Published in: Ophthalmic surgery, lasers & imaging Vol. 52; no. 2; pp. 62 - 69
• Main Authors: Goldberg, Roger A., Hill, Lauren F., Davis, Tatiana, Ruiz, Carlos Quezada
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ SLACK Incorporated 01.02.2021; Slack, Inc; SLACK INCORPORATED
• Subjects: Age related diseases; Biotechnology industry; Care and treatment; Clinical trials; Confidence intervals; Diabetic retinopathy; Eye diseases; Growth factors; Macular degeneration; Monoclonal antibodies; Patient outcomes; Patients; Vascular endothelial growth factor; Visual acuity; United States; California
• ISSN: 2325-8160; 2325-8179; 2325-8179
• DOI: 10.3928/23258160-20210201-02

BACKGROUND AND OBJECTIVE:To determine the potential impact on visual outcomes of delayed treatment initiation in patients with neovascular age-related macular degeneration (nAMD). PATIENTS AND METHODS:Post hoc analysis of anti-vascular endothelial growth factor treatment-naïve patients with nAMD from HARBOR. Time to treatment was defined as first ranibizumab injection date minus screening date. Comparisons were made between the prompt (≤ 6 days) versus delayed (> 10 days) treatment groups. Main outcome measures were best-corrected visual acuity (BCVA) change over time, BCVA, number of ranibizumab injections, and proportion of 3-line gainers/losers. RESULTS:In HARBOR, more than 50% of patients received their first injection within 7 days of screening, with mean (median) time to treatment of 4.6 (5) and 15.9 (14) days for the prompt and delayed treatment groups, respectively. Mean (95% confidence interval [CI]) BCVA change from baseline to Month 24 was 9.1 (7.4–10.8) and 8.8 (6.7–10.8) Early Treatment Diabetic Retinopathy Study letters in the prompt (n = 395) and delayed (n = 230) treatment groups, respectively. Mean (95% CI) total number of ranibizumab injections for the as-needed arms was 12.4 (11.6–13.3) and 11.4 (10.3–12.4) for the prompt and delayed treatment groups, respectively. CONCLUSION:In HARBOR, time from screening to first ranibizumab injection did not seem to significantly affect mean BCVA change or number of injections.[Ophthalmic Surg Lasers Imaging Retina. 2021;52:62–69.]