White Paper by Angiogenesis Foundation suggests some key action points to help control AMD

The AngiogenesisFoundation has announced release of the white paper, titled "Improving Long-Term Patient Outcomes for Exudative Age-Related Macular Degeneration". The Foundation, leading retina specialists, AMD patient advocacy groups, AMD patient advocates, and caregivers contributed to the white paper. It identifies current barriers to and solutions for improving the long-term vision outcomes of people living with exudative age-related macular degeneration, more commonly known as wet AMD.

As the number of people diagnosed with wet AMD increases, so does the demand for anti-vascular endothelial growth factor (anti-VEGF) treatments. Meeting this demand efficiently and economically has been a challenge for retina specialists and others in the ophthalmology community.

In addition, research into the treatment of wet AMD — particularly studies that focus on long-term and real-world outcomes — has recently begun to reveal new evidence about the relationship between patient outcomes and dosing frequency over the long term. As more researchers, clinicians, and patients use antiangiogenic therapies and as more studies involving these treatments are published, new questions have arisen about the best practices. These questions center on the timeliness of initial dosing and the optimal dosing frequency of the treatments, as well as on concerns about the diagnosis and long-term management of the disease. One major concern involves the undertreatment of patients over the long term, which may lead to devastating outcomes.

The purpose of the national summit that lead to this white paper was to determine how clinicians can better meet the needs of patients with wet AMD to ensure their vision is preserved as long as possible with anti-VEGF therapies as well as explore novel approaches to assist wet AMD patients in retaining functional vision. For additional analysis, the Angiogenesis Foundation convened a follow-up expert roundtable, consisting of six leading clinicians who provided further insights on the summit findings.


The following key actions were recommended:

1. Increase public awareness of AMD.

• Initiate a major, ongoing, multi-faceted awareness campaign for AMD so the at-risk age population, specifically patients with intermediate AMD who are at the highest risk for progression to wet AMD, is aware of the need for regular vision examinations and the role they play in maintaining functional vision should they develop wet AMD.
• Work with medical societies and medical schools to raise awareness of intermediate and wet AMD among trainees, primary care providers, and general ophthalmologists. Emphasize the critical role primary care providers and general ophthalmologists can play in helping patients retain good vision should they convert to wet AMD.

2. Improve early detection of wet AMD.

• Raise awareness of the availability and opportunity to benefit from early detection with homemonitoring devices. The ForeseeHome device, as well as other home-monitoring systems in development, support earlier detection and treatment of patients transitioning from dry to wet AMD. More patients need to be empowered to use these devices to detect disease progression from the convenience of their own home between routine examinations.

3. Develop and adopt evidence-based clinical practice guidelines.

• Use currently available registrational and long-term, real-world data to formulate a set of recommended retinal practice guidelines for anti-VEGF therapy.
• Enlist professional retina organizations to develop treatment protocol guidelines for using anti-VEGF agents for the long-term management of wet AMD.
• Share best practices and guidelines through an information clearinghouse to benefit the community of vision health care providers.

4. Acknowledge and address undertreatment as a cause of long-term vision loss.

• Increase awareness of the consequences of undertreatment and/or the interruption of treatment in clinician and patient communities.
• Identify and share ways to streamline retina specialist practices to improve treatment efficiency and reduce undertreatment.
• Package the reimbursement of treatment to include more services than the injection.

5. Treat the “whole patient.”

• Provide better, more holistic educational information to patients and their caregivers in the retina specialist’s office.
• Use support agencies to perform outreach to patients after their diagnosis and throughout treatment.
• Work with organizations such as the American Society of Retina Specialists, the American Academy of Ophthalmology, the Retina Society, the Macula Society, the Lighthouse Guild, and the American Macular Degeneration Foundation to develop a new standard of care for patients with wet AMD that takes a patient-centered approach to treatment.

6. Develop a real-world, long-term, late-stage research agenda.

• Mine existing registries for useful, valid data on long-term outcomes.
• Establish a real-world, long-term, late-stage treatment protocol study

References: The Angiogenesis Foundation News Release, Wikipedia (for picture)

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