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Real-world evidence in the use of Bevacizumab in age-related macular degeneration (ArMD): a scoping review

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Abstract

Purpose

Pharmacological treatments for age-related macular degeneration (ArMD) include anti-vascular endothelial growth factor therapies. Bevacizumab is used off-label, as it has no indication for ArMD. This study aims to identify and describe literature on real-world evidence of bevacizumab (originator or biosimilars) use in ArMD.

Methods

A scoping review was conducted in Medline, CINAHL and Embase databases. Studies published in English after September 2017, conducted in USA, including adults (≥ 18 years old) with ArMD who received treatment with bevacizumab for ArMD were included. The review was further limited to peer-reviewed observational studies that quantitatively analyze either clinical or patient-reported outcomes among patients treated with bevacizumab for ArMD.

Results

The search strategy retrieved 543 studies. After title and abstract screening, a total of 142 studies were selected for full-text review leading to a total of 12 studies qualifying for data charting. All were retrospective studies. Five (41.6%) of the studies had less than 500 eyes included in the analysis, and the rest had over a thousand eyes. All except one study reported clinical outcomes (visual acuity was the main outcome in 8 (66.6%) studies). There were 3 (25%) studies reporting adverse events of bevacizumab intravitreal injections. None of the studies specified using biosimilars for bevacizumab and none mentioned patient-reported outcomes.

Conclusion

The lack of studies aiming to study the patient-reported outcomes as well as the use of biosimilars of bevacizumab in ArMD makes this field a potential for future research. The different exposures and times to follow-up make it difficult to compare results among the selected studies.

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The authors declare that no funds, grants or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30S 2000E, Salt Lake City, UT, 84112, USA

    Ainhoa Gomez-Lumbreras, Priyanka Ghule, Rupesh Panchal, Theodoros Giannouchos & Diana Brixner

  2. University of Utah Health Plans, Murray, UT, USA

    Rupesh Panchal

  3. Department of Health Policy and Organization, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, 35233, USA

    Theodoros Giannouchos

  4. Biologics and Biosimilars Collective Intelligence Consortium, Alexandria, VA, USA

    Catherine M. Lockhart

  5. ZS, 2535 West Hillcrest Drive Suite 100, Thousand Oaks, CA, 91320, USA

    Rupesh Panchal

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  1. Ainhoa Gomez-Lumbreras
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Contributions

AGL participated in developing the study protocol and research design, was one of the reviewers of the manuscripts, provided the search strategy, charted and analyzed data, contributed to interpretation the data, and drafted the initial manuscript. PG reviewed the provided list of manuscripts from the search strategy, charted and analyzed data, contributed to interpretation the data, and reviewed the manuscript. RP and TG participated in developing the study protocol and research design, contributed to interpretation the data, and edited and reviewed the manuscript. DB and CL supervised the study, drafted the study protocol and research design, guided the analysis of the data, provided interpretation, and reviewed and edited the manuscript.

Corresponding author

Correspondence to Ainhoa Gomez-Lumbreras.

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This scoping review has been conducted using previously collected data. No need of informed consent or IRB approval was needed.

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Participants consent was not request as the study has been conducted using already collected and anonymous data.

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Gomez-Lumbreras, A., Ghule, P., Panchal, R. et al. Real-world evidence in the use of Bevacizumab in age-related macular degeneration (ArMD): a scoping review. Int Ophthalmol 43, 4527–4539 (2023). https://doi.org/10.1007/s10792-023-02853-5

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