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Real world data demonstrates efficacy of brolucizumab

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Brolucizumab was effective in the treatment of patients with nAMD, according to real-world data presented at ARVO 2021.

In the multi-center retrospective REBEL Study, patients with nAMD were evaluated after being treated with brolucizumab (Beovu; Novartis). Of the 282 eyes included, 63.9% switched from other anti-VEGF agents due to persistent disease activity and 32.3% due to desire to elongate treatment intervals. There was an average of 2.4 injections.

Treatment with brolucizumab was discontinued in 54.4% of patients, of which 86% did so out of caution after reports of intraocular inflammation (IOI) or occlusive vasculitis.

Adverse events occurred in 14 patients including 10 cases of IOI, 1 case of occlusive vasculitis, and 3 cases of pain.

After receiving ≥3 treatments, the proportion of patients with intraretinal fluid decreased from 34.5% to 27.2%), those with subretinal fluid decreased from 49.8% to 31.6%, and those with pigment epithelial detachments (PED) decreased from 59.8% to 54.6%. Improvements in visual acuity, central retinal thickness, and PED height were also found.

In another presentation, data from a post-marketing surveillance study, found brolucizumab to be safe and effective in patients with nAMD during the initial several months of use after its commercial release.

In the retrospective consecutive case series, 544 patients with nAMD treated at a private retina practice were included. All patients were treated with intravitreal injections (IVI) of brolucizumab regardless of treatment naivety or previous anti-VEGF therapy.

During the course of the 7.5 months study period, a total of 1438 brolucizumab IVIs were administered. Treatment-naïve eyes had a statically significant improvement in VA (+3.7 letters) whereas eyes that had been previously treated with a different anti-VEGF agent did not (-0.5 letters). A significant reduction in central subfield thickness, macular volume, presence of intraretinal fluid, presence of subretinal fluid, and presence of serous pigment epithelial detachment were observed In both groups.

Drug-related adverse events, including intraocular inflammation (n = 25), retinal vasculitis (n = 3), retinal artery occlusion (n = 1), and urticarial rash (n = 1), occurred after an average of 2.0 IVIs.

Aziz AA, et al. Real world efficacy and safety of brolucizumab in neovascular AMD: The REBEL Study. Presented at: ARVO 2021.

Walter SD, et al. Real-world efficacy and safety of brolucizumab. Presented at: ARVO 2021.

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