Patient preference of ranibizumab treatment regimen for neovascular age-related macular degeneration — monthly injections versus pro re nata

Abstract

To identify preference of treatment regimen in patients with anti-VEGF therapy for neovascular age-related macular degeneration (AMD) in real life. A cross-sectional study was conducted in 200 patients receiving ranibizumab therapy on a pro re nata regimen with monthly controls. One hundred and twenty-four patients were recruited in a tertiary health care clinic, and 76 patients were recruited in a private practice. Patients were asked to respond to a 14-item questionnaire covering items such as treatment burden and preference for treatment: either monthly injections or pro re nata. Mean time under anti-VEGF treatment was 33.7 months, and the mean number of intravitreal injections was 17.7. Despite a high treatment burden in 60.3% of patients, there was an acceptance rate for monthly examinations or injections of 93%. The proportion of patients who favoured a PRN regimen was 53.0%, whereas 37.9% of patients favoured continuous injections. Major concern was recurrent disease activity in 54.5%. We identified two groups of patients of considerable size who would prefer either monthly injections or as-required. Overall, there was a high acceptance rate despite a high treatment burden. Nevertheless, efforts should be undertaken to improve examination and injection procedures and to consider the patient's preference for a treatment regimen.