Risk of general IOI higher after brolucizumab injection compared to aflibercept in nAMD

Although there was no difference between brolucizumab injection and aflibercept injection in the incidence of severe sight-threatening intraocular inflammation (IOI) in patients with neovascular age-related macular degeneration (nAMD), a significantly higher risk of generalized IOI after brolucizumab relative to aflibercept was demonstrated in a new meta-analysis.

A systematic search identified 14 randomized controlled trials including 6759 eyes at baseline comparing IOI after intravitreal anti-vascular endothelial growth factor injections in nAMD.

The risk of endophthalmitis and retinal vascular occlusion was similar amongst agents.

Brolucizumab had a higher incidence of generalized IOI (risk ratio = 6.24, 95% confidence interval = [1.40-27.90]) and vitreous haze/floaters (risk ratio = 1.64, 95% confidence interval = [1.00-2.67]) when compared with aflibercept.

Reference
Patil NS, Dhoot AS, Popovic MM, et al. Risk of intraocular inflammation after injection of antivascular endothelial growth factor agents: A meta-analysis. Retina. 2022;42(11):2134-2142. doi: 10.1097/IAE.0000000000003582. PMID: 36269802.