Switching to brolucizumab: injection intervals and visual, anatomical and safety outcomes at 12 and 18 months in real-world eyes with neovascular age-related macular degeneration

International Journal of Retina and Vitreous

Original Article

Ryan Zubricky¹  Lujia Zhou²  Samriddhi Buxy Sinha³  Helene Karcher³  Nina Sonbolian³  Thomas P. Hull⁴  Margaret Fink⁴  Jasmyne McCoy⁴  Shawn A. Lewis⁴  Llewelyn J. Rao⁴  Hang Pham⁴  Sean M. Platt⁴  Joseph M. Coney⁴  Scott D. Pendergast⁴  Michael A. Novak⁴  David G. Miller⁴  Lawrence J. Singerman⁴  Jerome P. Schartman⁴  Richard Donkor⁴ 

[1] Geisinger Eye Institute, Danville, PA, USA;KMK Consulting, Morristown, NJ, USA;Novartis AG, Basel, Switzerland;Retina Associates of Cleveland Inc, 24075 Commerce Park, 44122, Beachwood, OH, USA;

关键词: Anti-VEGF;    Brolucizumab;    Beovu;    Injection intervals;    nAMD;    Neovascular age-related macular degeneration;    Switch patients;    Treatment burden;   

DOI  :  10.1186/s40942-023-00445-0

 received in 2022-10-17, accepted in 2023-01-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe anti-vascular endothelial growth factor (anti-VEGF) injection interval influences treatment burden and compliance in neovascular age-related macular degeneration (nAMD). This real-world study investigates visual acuity (VA), injection-interval extension, central macular thickness (CMT) and safety in nAMD eyes switched to the anti-VEGF agent brolucizumab and followed for up to 18 months.MethodsThis retrospective study included patients with nAMD who were switched from other anti-VEGF agents to brolucizumab only. Patient eyes were grouped into three nested cohorts with the overall cohort receiving ≥ 1 brolucizumab injection, the second receiving ≥ 3 brolucizumab injections with a follow-up period of ≥ 12 months and the third cohort receiving ≥ 3 brolucizumab injections with a follow-up period of ≥ 18 months. Study endpoints included changes from baseline at 12 or 18 months in VA, injection intervals, and CMT. Sub-group analyses were conducted using baseline injection interval length or baseline VA as qualifiers.ResultsOverall, 482 eyes received ≥ 1 brolucizumab injection; 174 eyes received ≥ 3 brolucizumab injections with ≥ 12 months of follow-up, and 95 eyes received ≥ 3 brolucizumab injections with ≥ 18 months of follow-up. VA (mean [95% confidence intervals]) remained stable relative to baseline after 12 months (− 1.1 [− 3.7, 1.6] letters; p = 0.42) and 18 months (0.0 [− 3.1, 3.1] letters; p = 0.98) of brolucizumab treatment, respectively, and pre-switch injection intervals or baseline VA had no notable effect. Following the switch to brolucizumab, injection intervals were extended from baseline to month 12 by 26.9 (19.7, 34.0) days (p < 0.0001), and eyes with pre-switch injection intervals < 8 weeks were able to have their injection intervals extended by 23.6 days longer than eyes with pre-switch injection intervals ≥ 8 weeks. At 18 months, injection intervals were extended by 36.3 (25.6, 46.9) days (p < 0.0001) compared to baseline. Following switch to brolucizumab, CMT was reduced at both 12 and 18 months (12 months: − 35.2 (− 51.7, − 18.8) µm, p < 0.0001; 18 months: − 38.9 (− 54.3, − 22.0) µm, p < 0.0001). Intraocular inflammation-related adverse events were reported in 4.6% of brolucizumab-treated eyes.ConclusionsThis real-world study demonstrates that injection intervals may be significantly extended with maintained vision and reduced CMT in nAMD eyes switching to brolucizumab therapy from other anti-VEGFs.

【 授权许可】

CC BY   
© The Author(s) 2023

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