Aflibercept Injection Into the Vitreous Body of the Eye: Study to Learn More About Patient Relevant Outcomes, Real World Treatment Patterns and How Well the Treatment Works for Patients Suffering From Abnormal Growth of New Blood Vessels Under the Retina.

Study Overview
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Brief Summary
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In this clinical study researchers want to gain a deeper understanding of treatment consistence under real world conditions over the course of 24 months of Aflibercept injections into the eye for patients suffering from abnormal growth of new blood vessels under the retina (neovascular age-related macular degeneration). The study aims to identify potential reasons that may allow classification of non-consistence as patient or physician driven. They want to describe treatment effectiveness (how well the treatment works) and associations between treatment effectiveness, non-consistence and patient relevant outcomes, such as vision specific quality of life and treatment satisfaction.

Official Title
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Intravitreal Aflibercept in Neovascular Age-related Macular Degeneration (nAMD): an Observational Study Assessing Patient Relevant Outcomes, Real-world Treatment Pattern and Effectiveness

Conditions
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Macular Degeneration

Intervention / Treatment
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* Drug: Ivt. Aflibercept (Eylea, BAY86-5321)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of neovascular age-related macular degeneration Decision to initiate treatment with intravitreal aflibercept was made as per investigator's routine treatment practice or current treatment with IVT-AFL (all prior anti-VEGF treatments must have been applied by the participating study site) No participation in an investigational program with interventions outside of routine clinical practice No contra-indications according to the local marketing authorization/ Summary of Product Characteristics (SmPC) Ability and willingness to participate in telephone interviews Exclusion Criteria: Any prior therapy with intravitreal steroids in the study eye. Concomitant therapy (except nutritional supplements) with any other agent to treat nAMD in the study eye Any prior transpupillary thermotherapy, photodynamic therapy, macular rotation/ translocation or macular laser in the study eye or Structural damage to the center of the macula in either eye Any other condition expected to permanently limit visual acuity outcomes over the course of the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with nAMD_Treatment-naive (anti-VEGF naive)<br>Observational period of therapy with intravitreal aflibercept (IVT-AFL) up to a maximum of 24 months | Drug: Ivt. Aflibercept (Eylea, BAY86-5321)<br>* Treatment is applied according to routine clinical practice and independent of the study setting.<br>|
| Patients with nAMD_Pre-treated with IVT-AFL<br>Observational period of therapy with intravitreal aflibercept (IVT-AFL) up to a maximum of 24 months | Drug: Ivt. Aflibercept (Eylea, BAY86-5321)<br>* Treatment is applied according to routine clinical practice and independent of the study setting.<br>|
| Patients with nAMD_Pre-treated with any anti-VEGF<br>Observational period of therapy with intravitreal aflibercept (IVT-AFL) up to a maximum of 24 months | Drug: Ivt. Aflibercept (Eylea, BAY86-5321)<br>* Treatment is applied according to routine clinical practice and independent of the study setting.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to first appearance of non-consistence | Non-consistence is: Failure of subjects to appear to a scheduled injection visit; Strong time deviation of injections from approved aflibercept posology. | Up to 24 months | 
| Reasons why a patient failed to appear to a scheduled injection visit | Asked in telephone interviews | Up to 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in best corrected visual acuity (BCVA) letters |  | From baseline to 4, 12 and 24 months | 
| Change in central retinal thickness (CRT) |  | From baseline to 4, 12 and 24 months | 
| Treatment satisfaction by MAC-TSQ | Treatment satisfaction is assessed with the MAC-TSQ (Macular Disease Treatment Satisfaction Questionnaire) consisting of 14 items (each item is scored from 0-6) resulting in a score range of 0-72 (a higher score represents better treatment satisfaction). | At 4, 12 and 24 months | 
| Change in treatment satisfaction | Comprises change in treatment satisfaction from 4 months to 12 and 24 months. Treatment satisfaction is assessed with the MAC-TSQ (Macular Disease Treatment Satisfaction Questionnaire) consisting of 14 items (each item is scored from 0-6) resulting in a score range of 0-72 (a higher score represents better treatment satisfaction). | From 4 month to 12 and 24 months | 
| Vision-specific quality of life by NEI VFQ-25 | Vision-specific quality of life is assessed with the NEI VFQ-25 (National Eye Institute Visual Function Questionnaire), i.e. a 25-item questionaire that gives a score on a scale from 0 (worst) to 100 (best = no vision problems). | At baseline, 4, 12 and 24 months | 
| Change in vision-specific quality of life | Comprises change in vision-specific quality of life between baseline and 4, 12 and 24 months. Vision-specific quality of life is assessed with the NEI VFQ-25 (National Eye Institute Visual Function Questionnaire), i.e. a 25-item questionaire that gives a score on a scale from 0 (worst) to 100 (best = no vision problems). | From baseline to 4, 12 and 24 months | 
| Burden of therapy | Descriptive measure summarising information about patient´s time for scheduling and attending appointments and anxiety reasons. Asked in telephone interviews. | At 4, 12 and 24 months | 
| Information about disease and treatment | Describes to what extent patients were informed about their disease and treatment. Asked in telephone interviews. | At 4, 12 and 24 months | 
| Willingness to continue therapy | Asked in telephone interviews | At 4, 12 and 24 months | 
| Reasons for treatment discontinuation | Asked in telephone interviews | At 4, 12 and 24 months | 
| Change in general quality of life by EQ-5D | General quality of life is assessed with EQ-5D ®, a 5-item questionnaire assessing 5 health related dimensions on 5 levels (% is calculated for each level) and complemented by a visual analogue scale (range 0-100, high score represents better quality of life). | From baseline to 12 and 24 months | 
| Percentage of non-persistent patients | Non-persistence is: Patients terminating treatment with aflibercept. | At 12 and 24 months | 
| Time from baseline to first instance of non-persistence | Non-persistence: Patients terminating treatment with aflibercept. | Up to 24 months | 
| Percentage of patients receiving 3 initial monthly injections |  | Up to 24 months | 
| Percentage of consistently treated patients | Non-consistence is: Failure of subjects to appear to a scheduled injection visit; Strong time deviation of injections from approved aflibercept posology. | At 12 and 24 months | 
| Proportion of patients undergoing therapeutic switch |  | At 12 and 24 months | 
| Reasons for therapeutic switching | Asked in telephone interviews | At 12 and 24 months | 
| Proportion of patients discontinuing disease monitoring at participating center |  | At 12 and 24 months | 
| Average time between visits |  | Up to 24 months | 
| Average time between injections in the study eye |  | Up to 24 months | 
| Number of injections in the study eye per year |  | Up to 24 months | 
| Number of visits per study eye per year | Comprises monitoring, injection and post-injection visits | Up to 24 months | 
| Number of visits in clinics/ ophthalmology practices other than the study center per year |  | Up to 24 months | 
| Number of examinations of the study eye per year | Comprises optical coherence tomography (OCT), visual acuity tests, funduscopy examinations or angiography examinations. | Up to 24 months | 
| Number of injections until start of observation | Only for pre-treated patients | At baseline | 
| Duration of treatment until start of observation | Only for pre-treated patients | At baseline | 
| Type of treatment until start of observation | Only for pre-treated patients | At baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neovascular age-related macular degeneration