Anti-Vascular Endothelial Growth Factor Treatment Discontinuation and Interval in Neovascular Age-Related Macular Degeneration in the United States

center dot PURPOSE: To assess the association between treat-ment interval and likelihood of anti-vascular endothelial growth factor (anti-VEGF) discontinuation among pa-tients with neovascular age-related macular degeneration (nAMD) in a real-world setting in the United States. center dot DESIGN: Retrospective clinical cohort study. center dot METHODS: Health insurance claims data from the IBM MarketScan Commercial and Medicare Supplemen-tal databases were retrospectively reviewed to identify adults with nAMD who received anti-VEGF for the first time between July 1, 2011, and June 30, 2017. The proportion of discontinued patients was analyzed using Kaplan-Meier curves. Cox proportional hazards models were used to examine the association between treatment intervals at 24 months and anti-VEGF discontinuation. center dot RESULTS: The analysis included 8167 patients on continuous, unilateral anti-VEGF treatment for at least 24 months. Baseline demographics and clinical charac-teristics were well balanced between treatment inter-val groups. The overall rate of discontinuation from 24 months until 60 months after treatment initiation was 30.4%. At 60 months, patients on shorter treatment in-tervals were more likely to remain on treatment than those on longer intervals, ranging from 76.8% (4-week interval group) to 60.6% ( > 12-week interval group) and corresponding to a 28% lower likelihood (HR [SE] 0.72 [0.12], P < .01) and 55% higher likelihood of discontin-uing treatment (HR [SE] 1.55 [0.07], P < .01), respec-tively, compared with the 8-week group. center dot CONCLUSIONS: nAMD patients on longer anti-VEGF treatment intervals at 24 months had consistently higher discontinuation rates than patients on shorter intervals in the following years. This highlights the need to sup-port and educate patients on long treatment intervals to continue with their treatment.