The impact of different anti-vascular endothelial growth factor treatment regimens on reducing burden for caregivers and patients with wet age-related macular degeneration in a single-center real-world Japanese setting

Objective: To describe the burden associated with different anti-vascular endothelial growth factor (VEGF) treatment strategies for wet age-related macular degeneration (wAMD) in a real-word setting in Japan. Methods: Single-center, cross-sectional survey of caregivers of patients with wAMD performed in a hospital in Mito-City, a rural area in Japan. Caregiver burden was evaluated using the Burden Index of Caregivers (BIC-11), and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression scale. Retrospective medical chart review was conducted to monitor resource use and visual acuity outcomes in patients. The productivity loss of caregivers accompanying patients on hospital visits was estimated using the human capital method. Results: Seventy-one patient-caregiver pairs were included. Most caregivers were female (74.6%), spouse/partner (54.9%), employed (46.5%), and the primary caregiver (85.9%). Patients received anti-VEGF treatment as follows: treat-and-extend (T&E; n = 42), switch (from as-needed [PRN] to T&E; n = 18), PRN (n = 10), and other (n = 1). Caregiver-related burden (total BIC-11 scores) were 4.29 (T&E) 4.60 (PRN), and 5.33 (switch) (p = NS). Conclusion: wAMD treatment with anti-VEGF agents via T&E reduced hospital visits compared with PRN, where associated monitoring visits are necessary to provide good patient outcomes. T&E was associated with a reduction trend in caregiver burden, including time and costs.