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AXPAXLI (axitinib intravitreal implant)

Neovascular age-related macular degeneration

Also known as OTX-TKI
Manufacturer
Ocular Therapeutix
Last updated
309 sources

Product information and disease descriptionPlace of product in therapyDisease descriptionEpidemiology

Incidence of Neovascular age-related macular degeneration

21 evidence topics · 15 sources

United States: annual incidence of neovascular AMD in White adults aged 50 years and older

“Annual incidence (estimated from prevalence) of late AMD in American whites was 3.5 per 1000 aged ≥50 years (95% credible interval 2.5, 4.7 per 1000), equivalent to 293 000 new cases in American whites per year (95% credible interval 207 000, 400 000). Incidence rates approximately quadrupled per decade in age. Annual incidence GA rates were 1.9 per 1000 aged ≥50 years, NVAMD rates were 1.8 per 1000. Late AMD incidence was 38% higher in women vs men (95% credible interval 6%, 82%).” (opens the source at this quote in a new tab)

United States: 3-year incidence of exudative AMD in Medicare beneficiaries

“Overall, the 3-year incidence of exudative AMD is estimated to be between 9.4 per 1000 and 11.4 per 1000 Americans age 65 and older (depending on ascertainment criteria), based on those diagnosed and treated by ophthalmologists for the condition.” (opens the source at this quote in a new tab)

“Women were found to have a slightly higher incidence of AMD than men using all ascertainment criteria (P < 0.001), and white Americans were found to have a fivefold-to-sixfold higher ascertainment criteria than black Americans (P < 0.001).” (opens the source at this quote in a new tab)

United States: 15-year cumulative incidence in the Beaver Dam Eye Study

“The 15-year cumulative incidence was 14.3% for early AMD (the presence of either soft indistinct drusen or the presence of pigmentary abnormalities together with any type of drusen) and 3.1% for late AMD (presence of exudative AMD or geographic atrophy).” (opens the source at this quote in a new tab)

“Individuals > or = 75 years of age at baseline had significantly (P<0.01) higher 15-year incidences of the following characteristics than people 43 to 54 years of age: larger drusen (125 mum in diameter, 24.1% vs 10.6%), soft indistinct drusen (18.7% vs 6.5%), retinal pigmentary abnormalities (20.2% vs 3.7%), exudative macular degeneration (4.4% vs 0.4%), and pure geographic atrophy (3.2% vs 0%).” (opens the source at this quote in a new tab)

United States: 8-year incidence of late AMD by race and ethnicity

“A prospective cohort study of 3811 participants aged 46 to 86 years residing in the US reported an 8-year incidence of late-stage AMD of 0.4% for people who were Black, 2.2% for people who were Chinese, 0.8% for people who were Hispanic, and 4.1% for people who were White.” (opens the source at this quote in a new tab)

United States: newly diagnosed neovascular AMD in the IRIS Registry, 2016 to 2021

“Among the 918 759 patients with nAMD (61.5% female, 82.3% White), male, Black, and Hispanic patients demonstrated nAMD at younger ages (P < 0.001).” (opens the source at this quote in a new tab)

“Overall, the mean ± standard deviation (SD) age at nAMD presentation was 80.2 ± 9.1) years.” (opens the source at this quote in a new tab)

Europe: pooled annual incidence of late AMD

“In the meta-analysis of incidence, the pooled annual incidence of any late AMD was 1.4 per 1 000 individuals (95% CI 0.8 to 2.6).” (opens the source at this quote in a new tab)

“Incident late AMD is estimated to increase from 400 000 per year today to 700 000 per year in 2050.” (opens the source at this quote in a new tab)

Progression to late AMD: AREDS simplified severity scale

“Risk factors are summed across both eyes, yielding a 5-step scale (0-4) on which the approximate 5-year risk of developing advanced AMD in at least one eye increases in this easily remembered sequence: 0 factors, 0.5%; 1 factor, 3%; 2 factors, 12%; 3 factors, 25%; and 4 factors, 50%.” (opens the source at this quote in a new tab)

Progression to late AMD: updated simplified severity scale incorporating reticular pseudodrusen

“As the final Simplified Severity Scale, the five-year progression rates for levels 0–4, respectively, were 0.3%, 4.3%, 11.6%, 26.7%, and 50.0%, for participants without RPD at baseline, and 2.8%, 8.0%, 29.0%, 58.7%, and 72.2%, for participants with RPD at baseline.” (opens the source at this quote in a new tab)

Progression to neovascular AMD: AREDS eyes free of late AMD at baseline

“In the 5-year follow-up period (years 2-7), 486 of 7223 (6.7%) of eyes developed NV AMD, 339 of 7253 (4.7%) developed CGA, 726 of 7246 (10.0%) developed any GA, 2622 of 7095 (37.0%) had at least 2-line BCVA loss, and 1494 of 7155 (20.9%) had at least 3-line BCVA loss.” (opens the source at this quote in a new tab)

Progression from early AMD in the AREDS

“Participants with extensive small drusen, nonextensive intermediate size drusen, or pigment abnormalities had only a 1.3% 5-year probability of progression to advanced AMD.” (opens the source at this quote in a new tab)

Fellow-eye conversion: AAO Preferred Practice Pattern summary

“In the AREDS, the risk of progression for patients with advanced AMD in one eye to an advanced stage in the fellow eye ranged from 35% to 50% at 5 years, depending largely on the phenotype in the better eye.” (opens the source at this quote in a new tab)

Fellow-eye conversion: CATT participants receiving anti-VEGF therapy

“Among 1185 CATT participants, 727 (61%) had no CNV in the fellow eye at enrollment. At two years, CNV had developed in 75 (20.6%) of 365 patients treated with ranibizumab and 60 (16.6%) of 362 patients treated with bevacizumab (absolute difference 4.0%, 95% confidence interval (−1.7%, 9.6%); p=0.17).” (opens the source at this quote in a new tab)

“Incidence was not associated with genotype on rs1061170 (CFH), rs10490924 (ARMS2), rs11200638 (HTRA1), and rs2230199 (C3) (p > 0.35).” (opens the source at this quote in a new tab)

Fellow-eye conversion: UK National Health Service database

“When fellow eyes with baseline VA worse than 20/200 were excluded to restrict analyses to eyes at risk of nAMD, the rate of second-eye involvement was 14.0% per year (42%/3 years).” (opens the source at this quote in a new tab)

Fellow-eye conversion: Fight Retinal Blindness! registry

“The cumulative incidence of second eye involvement was 54% over 5 years.” (opens the source at this quote in a new tab)

Fellow-eye conversion: untreated neovascular AMD

“Neovascular AMD developed in the fellow eye in 12.2% of patients by 12 months and in 26.8% by 4 years.” (opens the source at this quote in a new tab)

United States: annual incidence of neovascular AMD in White adults aged 65 years and older and 80 years and older

“In those aged 65 years and older the annual incidence rate for late AMD is 7.8 per 1000 (95% credible interval 5.5, 10.6), 4.3 per 1000 for GA (95% credible interval 2.9, 6.2), and 3.9 per 1000 for NVAMD (95% credible interval 2.7, 5.5).” (opens the source at this quote in a new tab)

“In those aged 80 years and older the annual incidence rates per 1000 are 19.4 (95% credible interval 13.8, 26.2), 10.9 (95% credible interval 7.2, 16.1), and 9.9 (95% credible interval 6.8, 14.0), respectively.” (opens the source at this quote in a new tab)

“This corresponds to approximately 293 000 new cases of late AMD each year (95% credible interval 207 000, 400 000), and 160 000 (95% credible interval 107 000, 234 000) and 148 000 (95% credible interval 103 000, 207 000) for GA and NVAMD, respectively.” (opens the source at this quote in a new tab)

United States: late AMD and neovascular AMD incidence rates in women compared with men

“For all age groups (except the youngest), women have a slightly higher annual incidence rate of late AMD (4 per 1000, 95% credible interval 2.3, 6.6) than men (2.4 per 1000, 95% credible interval 1.4, 4.2; Table 3).” (opens the source at this quote in a new tab)

“In those aged 65 years and older the incidence rates of NVAMD within each 5-year age group are higher in women than in men.” (opens the source at this quote in a new tab)

“Under 70 years of age the number of incident cases is similar in men and women.” (opens the source at this quote in a new tab)

United States: rate of increase in late AMD incidence per decade of age by estimation method

“A meta-analysis of incidence studies showed that the incidence rate for late AMD triples per decade increase in age (rate ratio 2.9; 95% credible interval 2.6, 3.2, Table 2).” (opens the source at this quote in a new tab)

“In proportionate terms, annual incidence rates from prevalent studies suggest a quadrupling in risk per decade, whereas the meta-analysis of incidence studies suggests a tripling.” (opens the source at this quote in a new tab)

“Although late AMD incidence increases log-linearly with age, the absolute number of incident cases of late AMD decreases beyond the age of about 85 years because of increased mortality.” (opens the source at this quote in a new tab)

United States: 3-year incidence of exudative AMD in Medicare beneficiaries by ascertainment criterion

“As shown in Table 4, the 3-year estimated incidence of exudative macular degeneration in the Medicare population ranges from 0.37% (95% confidence interval [CI], 0.35, 0.38) to 1.14% (95% CI, 1.12, 1.16), depending on the ascertainment criteria chosen.” (opens the source at this quote in a new tab)

“Extrapolating from the published report, the 5-year incidence of exudative AMD in persons aged 65 and older is 1.48% (95% CI, 0.80%, 2.16%).” (opens the source at this quote in a new tab)

United States: person-level rather than eye-level counting in the Medicare incidence estimate

“In this study, we have attempted to measure the 3-year per-person incidence, as opposed to the per-eye incidence of exudative AMD.” (opens the source at this quote in a new tab)

“The lack of information on laterality in the Medicare database makes it impossible to estimate the incidence of exudative AMD per eye.” (opens the source at this quote in a new tab)

United States: age gradient and coverage limits of the Medicare claims-based estimate

“As shown in Figure 2, the incidence of exudative AMD increases linearly with age, but seems to level off at the oldest age group. There is no biological basis to suggest a decrease in true incidence.” (opens the source at this quote in a new tab)

“Approximately 20% of Medicare beneficiaries aged 65 to 74 years and 18% of beneficiaries aged 75 to 85 years join Medicare HMOs.” (opens the source at this quote in a new tab)