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Real-world incidence of endopthalmitis after intravitreal anti-VEGF injections in Korea: findings from the Common Data Model in ophthalmology
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Yongseok Mun, Seng Chan You, Da Yun Lee, Seok Kim, Yoo-Ri Chung, Kihwang Lee, Ji Hun Song, Young Gun Park, Young Hoon Park, Young-Jung Roh, Se Joon Woo, Kyu Hyung Park, Rae Woong Park, Sooyoung Yoo, Dong-Jin Chang, Sang Jun Park
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Epidemiol Health. 2021;43:e2021097. Published online November 9, 2021
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DOI: https://doi.org/10.4178/epih.e2021097
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 Abstract
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Abstract
OBJECTIVES
The aim of this study was to evaluate the real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections using data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).
METHODS Patients with endophthalmitis that developed within 6 weeks after intravitreal anti-VEGF injections were identified in 3 large OMOP CDM databases.
RESULTS We identified 23,490 patients who received 128,123 intravitreal anti-VEGF injections. The incidence rates of endophthalmitis were 15.75 per 10,000 patients and 2.97 per 10,000 injections. The incidence rates of endophthalmitis for bevacizumab, ranibizumab, and aflibercept (per 10,000 injections) were 3.64, 1.39, and 0.76, respectively. The annual incidence has remained below 5.00 per 10,000 injections since 2011 despite the increasing number of intravitreal anti-VEGF injections. Bevacizumab presented a higher incidence rate for endophthalmitis than ranibizumab and aflibercept (incidence rate ratio, 3.17; p=0.021).
CONCLUSIONS The incidence of endophthalmitis after intravitreal anti-VEGF injections has stabilized since 2011 despite the explosive increase in anti-VEGF injections. The off-label use of bevacizumab accounted for its disproportionately high incidence of endophthalmitis. The OMOP CDM, which includes off-label uses, laboratory data, and a scalable standardized database, could provide a novel strategy to reveal real-world evidence, especially in ophthalmology.
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Summary
Korean summary
- 공통데이터모델 (Observational Medical Outcomes Partnership Common Data Model, OMOP CDM)을 통해 유리체강내 항혈관내피성장인자 주입술 후 발생한 안내염의 실세계 발생률 (Real-world incidence)은 1만명 당 15.75명, 주사 1만회 당 2.97회였음을 알 수 있었다.
- 베바시주맙에서 다른 항혈관내피성장인자에 비해 유리체강내 주사 후 안내염 발생 비율이 높았으며, 이는 약제의 분주로 인한 오염과 관련이 있을 것이다.
- 공통데이터모델은 건강보험 청구자료가 포함하지 않는 유리체강내 베바시주맙 사용과 같은 오프라벨 의약품 사용 자료까지 포함하기 때문에, 유리체강내 항혈관내피성장인자 주입 후 발생한 안내염의 인구기반 발생률 추정을 가능케 했다.
Key Message
- The real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injections was 15.75 per 10,000 patients and 2.97 per 10,000 injections based on data from the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).
- Patients treated with bevacizumab showed a significantly higher incidence rate of post-injection endophthalmitis, which might have resulted from contamination related to the division of bevacizumab.
- OMOP CDM provides insights into the population-based incidence rate of endophthalmitis since it covers off-label prescriptions including intravitreal bevacizumab, which the national claims database does not cover.
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Citations
Citations to this article as recorded by  - Risk of post‐injection endophthalmitis peaks within the first three injections of anti‐vascular endothelial growth factor therapy: A nationwide registry‐based study
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Journal of the Korean Ophthalmological Society.2023; 64(8): 700. CrossRef - Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome
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Scientific Reports.2022;[Epub] CrossRef - Blueprint for harmonising unstandardised disease registries to allow federated data analysis: prepare for the future
Johannes A. Kroes, Aruna T. Bansal, Emmanuelle Berret, Nils Christian, Andreas Kremer, Anna Alloni, Matteo Gabetta, Chris Marshall, Scott Wagers, Ratko Djukanovic, Celeste Porsbjerg, Dominique Hamerlijnck, Olivia Fulton, Anneke ten Brinke, Elisabeth H. Be
ERJ Open Research.2022; 8(4): 00168-2022. CrossRef - Towards effective data sharing in ophthalmology: data standardization and data privacy
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Current Opinion in Ophthalmology.2022;[Epub] CrossRef
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