Reasons for anti-vegf treatment discontinuation in real clinical practice: results of a phone survey of patients with macular diseases

Background. Anti-VEGF therapy is currently regarded as the “gold standard” for the treatment of many macular diseases, while the results of its application in real clinical practice are often inferior to those from randomized clinical trials.

Materials and methods. A study group was formed on the basis of a retrospective analysis of the medical data of patients who received anti-VEGF therapy with ranibizumab and/or aflibercept according to registered indications, and who discontinued their follow-up in the clinic (n = 214). A phone survey of patients concerning the reasons for loss to follow-up with a statistical analysis of the obtained data was carried out.

Results. The majority of patients (81.3%) discontinued observation in the clinic within two years from the start of therapy (the median duration of treatment was 7 (3; 18) months). Patients with all considered diseases had an increase in best corrected visual acuity during treatment (p < 0.000001), which confirms the high efficiency of the method. According to the results of the phone survey, the following categories of respondents were identified: complete cessation of treatment – 120 (56.1%) patients, change of clinic – 20 (9.3%), death – 23 (10.7%), status not established – 51 (23.8%). The most frequent reasons for stopping treatment were dissatisfaction with its results (59 cases; 49.2%), financial burden (49; 40.8%), and systemic comorbidities (24; 20.0%).

Conclusion. Searching approaches to increase patients’ treatment adherence is one of the priorities for improving anti-VEGF therapy.