Study reveals growing treatment burden of retinal diseases in Finland

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Finnish researchers, Hanna Heloterä, Anna-Mari Viita, and Juha Laine, reported the results of a study in which they gained a better perspective on registry data and the changing workload in Ophthalmology resulting from the increased use of anti-vascular endothelial growth factor (VEGF) drugs to treat retinal diseases.¹

The researchers are from Roche Oy, Espoo, Finland; Department of Ophthalmology, University of Eastern Finland, Kuopio, Finland, and the InFLAMES Flagship, University of Turku, Turku, Finland.

They explained that with the introduction of intravitreal anti-VEGF inhibitors, patients now have more options to treat neovascular AMD (nAMD), diabetic macular edema (DME), retinal vein occlusion (RVO), and myopic choroidal neovascularization (mCNV). The increased number of effective treatments and the aging of the population have resulted in an increased treatment burden in Ophthalmology clinics.

They conducted a study to determine the changes in the numbers of patients being treated as the result of aging of the population and negative lifestyle changes and the numbers of treatments with the goal of providing solutions to manage the workload and productivity in Ophthalmology departments. In addition, the investigators pointed out, the registry data landscape has evolved in Finland in recent years. In light of this, they considered it important to gain an understanding the possibilities and limitations of Ophthalmology registries and patient information systems.

The study was a retrospective analysis of registry data from patients who received intravitreal injections from 2015 to 2022.The study focused on patients receiving and initiating intravitreal anti-VEGF treatment with ranibizumab (Lucentis, Genentech), aflibercept (Eylea, Regeneron Pharmaceuticals), and bevacizumab (Avastin, Genentech) for wet AMD, DME, RVO, and mCNV.

Registry data analysis

“The ophthalmology department workload increased significantly during our observation period as the total number of patients for nAMD, DME, RVO, and mCNV increased 199.6% from 2015 to 2021. In addition, the total number of administered anti-VEGF injections increased during our observation period, but the increase rate began to subside (2019–2020: increase 23.7%; 2020–2021: increase 10.3%; 2021–2022: increase 6.7%), the researchers said.

Regarding new patients, they reported that the total annual number of new patients for all diagnoses considered varied between 255 and 458 for the years 2015 to 2021, whereas the total number of new patients starting anti-VEGF treatment for DME, nAMD, RVO, and myopic CNV ranged from 489 to 572 in 2019 to 2021.

The largest number of patients were treated for nAMD. The investigators found the number of patients diagnosed with DME was about the same from approximately the same during 2015 to 2020, in contrast to the 73.8% increase in the number of patients with AMD (n=191, 2015; n=332, 2021); during that same period there was an 188.5% increase in the number of patients with RVO (2015 n=26; 2021, n=75). However, the number of patients with mCNV stayed low throughout the observational period, they described.

The authors concluded, “In the future, the number of patients with retinal vascular diseases is expected to increase due to the aging population and changes in lifestyle-related issues. Therefore, the use of registries in creating an evidence-based understanding of evolving patient numbers is critical. However, it is important to understand the limitations and the quality of the registries. Our study led to a heightened understanding of the Finnish registry landscape and demonstrated an increased workload by intravitreal injections in Ophthalmology departments. Confidently these data will facilitate discussions about changing resource needs in ophthalmology departments and registry studies in the future.”

Reference

1. Heloterä H, Viita AM, Laine J. Evolution of workload associated with anti-VEGF treatments for AMD, DME, RVO and mCNV in hospital district of Southwest Finland. Clin Ophthalmol. 2024;18:3645-3655; https://doi.org/10.2147/OPTH.S479816