Brolucizumab injection improves vision in eyes with neovascular AMD

A team of investigators in the UK has found that 1 injection of brolucizumab (Beovu, Novartis) treatment can result in a median improvement in visual acuity (VA) of 10.5 letters.

The investigators also found that the drug was well tolerated by patients with neovascular age-related macular degeneration (nAMD), according to first author Dr Cristina Cristian from the Department of Ophthalmology at Leeds Teaching Hospitals National Health Service Trust.

The drug was approved recently in the UK for treating nAMD. An advantage found in clinical trials was that the results achieved with injections at 8- or 12-week intervals were non-inferior to treatment with aflibercept (Eylea, Regeneron Pharmaceuticals Inc.) administered every 8 weeks.

According to Cristian, speaking at the EURETINA 2021 Virtual Congress, the advantages of 12-week dosing is a reduction in the number of patient visits and injections.

This is particularly important during the COVID-19 pandemic when maintaining social distancing is key to health and safety.

Cristian and her colleagues conducted a retrospective observational study to assess the efficacy and the risk profile of brolucizumab intravitreal injections in patients with an insufficient response to aflibercept characterized by persistent disease activity and unstable VA despite frequent therapy or disease control but a heavy treatment burden.

The charts of 35 patients (age range, 66-93 years; 51% women) with nAMD who were treated with brolucizumab from April 2020 to April 2021 were reviewed.

For all patients, the best-corrected VA, central retinal thickness, and intraocular pressure were measured; all patients underwent a complete ophthalmic examination at baseline and the last follow-up after the brolucizumab injection.

The patients received a total of 102 injections of brolucizumab; they had received from 3 to 62 previous aflibercept injections (median, 17; median injection interval, 6 weeks).

The median VAs before and after the brolucizumab injection were 57 and 67.5 letters, respectively; the respective central retinal thickness measurements were 337 μm and 436 μm.

The investigators reported that the treatment was well tolerated with no adverse events.

“The median VA improvement after the first injection was 10.5 letters despite the median increase in the central retinal thickness of 112.5 μm after the first dose of brolucizumab,” Cristian concluded. “No intraocular inflammation or vascular retinitis was detected in this case series.”

She also advised that conclusions about long-term results cannot be drawn.

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