Do published trial results influence physician prescribing patterns? Intravitreal antivascular endothelial growth factor usage by the United States Ophthalmologists before and after Protocol T study. Issue 3 (1st May 2023)

• Record Type: Journal Article
• Authors: Shah, Serena; Markatia, Zahra; Watane, Arjun; Feldman, Alexandra; Shah, Lea; Sridhar, Jayanth
• Is Part Of: Current opinion in ophthalmology. Volume 34:Issue 3(2023)
• Page Start: 218
• Page End: 225
• Publication Date: 2023-05-01
• Subjects: aflibercept -- antivascular endothelial growth factor -- bevacizumab -- diabetic macular oedema -- ranibizumab; Ophthalmology -- Periodicals; Eye Diseases -- Indexes; Eye Diseases -- Periodicals; Review Literature -- Indexes; Review Literature -- Periodicals; Vision Disorders -- Indexes; Vision Disorders -- Periodicals; 617.7
• DOI: 10.1097/ICU.0000000000000944
• Languages: English
• ISSNs: 1040-8738

Abstract

Abstract : Purpose of review: Clinical trial publications may influence physician prescribing patterns. The Diabetic Retinopathy Clinical Research Network (DRCR.net) Protocol T study, published in 2015, examined outcomes of intravitreal antivascular endothelial growth factor (VEGF) medications for treatment of diabetic macular oedema (DME). This study investigates if the Protocol T 1-year results were associated with changes in prescribing patterns. Recent findings: Anti-VEGF agents have revolutionized treatment of DME by blocking angiogenesis signalled by VEGF. Three commonly used anti-VEGF agents are on-label aflibercept (Eylea, Regeneron) and ranibizumab (Lucentis, Genentech) and off-label bevacizumab (Avastin, Genentech). Summary: From 2013 to 2018, there was a significant positive trend in the average number of aflibercept injections for any indication ( P < 0.002). There was no significant trend in the average number of bevacizumab ( P = 0.09) and ranibizumab ( P = 0.43) for any indication. The mean proportion of aflibercept injections per provider per year was 0.181, 0.217, 0.311, 0.403, 0.419 and 0.427; each year-by-year comparison was significant (all P < 0.001), and the largest increase was in 2015, the year of publication of Protocol T 1-year results. These results imply and reinforce that clinical trial publications may have significant effects on ophthalmologist prescribing patterns.