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. 2023 Nov 23:17:3601-3611.
doi: 10.2147/OPTH.S432957. eCollection 2023.

One-Year and 18-Month Outcomes in nAMD Patient Eyes Switched to Brolucizumab Alone versus to Brolucizumab Alternating with Other Anti-VEGF Agents

Joseph M Coney  1 , Jasmyne E McCoy  1 , Samriddhi Buxy Sinha  2 , Nina Sonbolian  2 , Lujia Zhou  3 , Thomas P Hull  1 , Shawn A Lewis  1 , David G Miller  1 , Michael A Novak  1 , Scott D Pendergast  1 , Hang Pham  1 , Sean M Platt  1 , Llewelyn J Rao  1 , Jerome P Schartman  1 , Lawrence J Singerman  1 , Richard Donkor  1 , Margaret Fink  1 , Ryan Zubricky  4 , Helene Karcher  2
Affiliations

One-Year and 18-Month Outcomes in nAMD Patient Eyes Switched to Brolucizumab Alone versus to Brolucizumab Alternating with Other Anti-VEGF Agents

Joseph M Coney et al. Clin Ophthalmol. .

Abstract

Objective: Retrospective, real-world study to evaluate visual acuity (VA), anti-vascular endothelial growth factor (anti-VEGF) injection intervals, and central macular thickness (CMT) in neovascular age-related macular degeneration (nAMD) eyes switched to brolucizumab only or to brolucizumab alternating with another anti-VEGF.

Methods: The overall study population comprised eyes that were given ≥1 brolucizumab injection between 1 October 2019 and 30 November 2021. The brolucizumab-only (BRO) cohort consisted of prior anti-VEGF-treated eyes treated exclusively with ≥3 brolucizumab injections over ≥12 or ≥18 months; the alternating brolucizumab (ALT) cohort comprised prior anti-VEGF-treated eyes treated with ≥2 brolucizumab injections and ≥1 other anti-VEGF over ≥12 or ≥18 months.

Results: A total of 482 eyes received ≥1 brolucizumab injection during the study period. Mean VA changes from baseline were -1.1±15.1 letters (BRO cohort; n = 174) and 1.3±13.0 letters (ALT cohort; n = 47) at Month 12, and 0.0±13.5 letters (BRO cohort; n = 95) and -7.3±17.2 letters (ALT cohort; n = 29) at Month 18. Mean changes in injection intervals were +26.9±48.1 days (BRO cohort) and +11.1±17.3 days (ALT cohort) at Month 12 and +36.3±52.3 days (BRO cohort) and +14.0±19.9 days (ALT cohort) at Month 18. Mean changes in CMT were -35.2±108.1 μm (BRO cohort) and -31.5±91.2 μm (ALT cohort) at Month 12 and -38.9±75.0 μm (BRO cohort) and -9.0±59.9 μm (ALT cohort) at Month 18. Intraocular inflammation-related adverse events were recorded in 22/482 (4.6%) eyes.

Conclusion: Treatment with either brolucizumab alone or brolucizumab alternating with another anti-VEGF can preserve vision, reduce CMT, and extend anti-VEGF injection intervals in patients with nAMD.

Keywords: 12-month outcomes; 18-month outcomes; alternating anti-VEGF treatments; brolucizumab; neovascular age-related macular degeneration; wet age-related macular degeneration.

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Conflict of interest statement

NS and HK are Novartis employees and HK is a Novartis shareholder. SBS was a Novartis employee at the time of this study and is a current employee of the Novartis Sandoz division. LZ is an employee of KMK Consulting, which was paid by Novartis to conduct the statistical analysis of the study. JMC has received grants from Aerpio, Alcon Laboratories, Alimera Sciences, Allergan/AbbVie, Apellis, Genentech, Hoffman La Roche, MacTel, National Eye Institute, Novartis, Regeneron and RegenexBio, consulting fees from Alimera Sciences, Apellis and RegenexBio, honoraria from Alimera Sciences, Allergan/AbbVie, Apellis, Genentech, Iveric Bio, Novartis, Regeneron and RegenexBio. DM reports consultancy fees and Speakers’ Bureau honoraria from Regeneron Pharmaceuticals. LS has received grants from Alkeus, Apellis, Genentech, Ionis Pharm, NGM, Biopharmaceuticals, Graybug Vision and Kodiak Sciences. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Definition of the brolucizumab, BRO and ALT cohorts.
Figure 2
Figure 2
Anti-VEGF agents and injection intervals for eyes in the 12-month (A) BRO cohort (n=174 eyes) and (B) ALT cohort (n=47 eyes).
Figure 3
Figure 3
Mean change in (A) injection intervals and (B) CMT from baseline to Month 12 in the BRO and ALT cohorts.
See this image and copyright information in PMC

References

    1. Wong WL, Su X, Li X, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(2):e106–16. doi:10.1016/S2214-109X(13)70145-1 - DOI - PubMed
    1. Ayoub T, Patel N. Age-related macular degeneration. J R Soc Med. 2009;102(2):56–61. doi:10.1258/jrsm.2009.080298 - DOI - PMC - PubMed
    1. Brown DM, Kaiser PK, Michels M, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1432–1444. doi:10.1056/NEJMoa062655 - DOI - PubMed
    1. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419–1431. doi:10.1056/NEJMoa054481 - DOI - PubMed
    1. Heier JS, Brown DM, Chong V, et al. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012;119(12):2537–2548. doi:10.1016/j.ophtha.2012.09.006 - DOI - PubMed

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