Factors Linked to Injection Interval Extension in Eyes with Wet Age-Related Macular Degeneration Switched to Brolucizumab

MacCumber, Mathew W.; Wykoff, Charles C.; Karcher, Hélène; Adiguzel, Eser; Sinha, Samriddhi Buxy; Vishwakarma, Saloni; LaPrise, Andrew; Igwe, Franklin; Freitas, Rita; Ip, Michael S.; Zarbin, Marco A.

doi:10.1016/j.ophtha.2023.03.017

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…A potential reason for the uncertain efficacy of PDT observed in the PLANET study could be the varying efficacies of the individual drugs. Furthermore, brolucizumab has demonstrated superior efficacy in achieving anatomical outcomes compared to other anti-VEGF drugs [ 36 ], along with significant effectiveness in treatment switching [ 14 ]. These findings indicate its potential as an effective treatment for nAMD that is resistant to other therapies.…”

Section: Discussionmentioning

confidence: 99%

“…Identifying efficacious second-line treatments is essential for patients unresponsive to anti-VEGF therapy, with the goal of preserving vision and alleviating the financial impact on both individuals and society [ 13 ]. The standard approach to treating refractory nAMD at present includes switching to other anti-VEGF medications and combination therapies utilizing PDT [ 10 – 12 , 14 – 17 ]. Brolucizumab, recently approved, exhibits considerable effectiveness when employed as second-line treatment for nAMD [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The standard approach to treating refractory nAMD at present includes switching to other anti-VEGF medications and combination therapies utilizing PDT [ 10 – 12 , 14 – 17 ]. Brolucizumab, recently approved, exhibits considerable effectiveness when employed as second-line treatment for nAMD [ 14 , 15 ]. In comparison, PDT outperformed anti-VEGF drugs monotherapy in treatment-naïve eyes with PCV, and also showed potential benefits for patients resistant to anti-VEGF therapy [ 7 , 10 – 12 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluating photodynamic therapy versus brolucizumab as a second-line treatment for polypoidal choroidal vasculopathy

Funatsu,

Terasaki,

Mihara

et al. 2024

Int J Retin Vitr

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Background To compare the one-year outcomes between intravitreal brolucizumab (IVBr) monotherapy and photodynamic therapy (PDT) as a second-line treatment in patients with polypoidal choroidal vasculopathy (PCV) who did not respond to first-line therapy. Methods This case–control study included eyes with PCV that do not respond to aflibercept or ranibizumab. The patients were retrospectively registered. We compared outcomes, including best-corrected visual acuity (BCVA), anatomical results, and the need for additional treatments, between IVBr and a combination therapy using PDT as second-line treatments for refractory PCV, after adjusting for potential confounders. We analyzed E-values to evaluate the robustness of the results against unmeasured confounders. Results Twenty-two eyes received IVBr, and twenty-four underwent PDT. No apparent differences were observed in BCVA and central macular thickness (CMT) changes from baseline between the groups (IVBr vs. PDT: BCVA, 0.01 ± 0.47 logMAR vs. 0.04 ± 0.18 logMAR, P-value = 0.756; CMT: − 36.3 ± 99.4 μm vs. − 114.7 ± 181.4 μm, P-value = 0.146). Only in the PDT group, five eyes (20.8%) did not require additional treatment after the second-line treatment, the adjusted odds ratio indicating no further treatment needed was 11.98 (95% confidence interval: 1.42–2070.07, P-value = 0.019). The E-value for the adjusted odds ratio was 23.44. Conclusions Both second-line treatments for PCV exhibited similar visual and anatomical outcomes. Only in the PDT-treated eyes were there some patients who did not require further treatment after second-line therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluating photodynamic therapy versus brolucizumab as a second-line treatment for polypoidal choroidal vasculopathy

Funatsu,

Terasaki,

Mihara

et al. 2024

Int J Retin Vitr

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“…We found a higher proportion of dry macula and a lesser extension of the injection interval than previous studies. In the extension of the injection interval by switching to brolucizumab, previous reports demonstrated that nAMD patients treated with a shorter injection interval before switching showed a longer extension of the injection interval [ 16 , 17 ]. Coney et al reported that eyes with preswitch injection intervals <8 weeks showed a 23.6-day longer extension of the injection interval than those with preswitch injection intervals ≥8 weeks.…”

Section: Discussionmentioning

confidence: 99%

The Effect of a Loading Dose Regimen in the Switch to Brolucizumab for Patients with Aflibercept-Resistant nAMD

Kamao,

Mitsui,

Date

et al. 2024

Journal of Ophthalmology

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Purpose. To evaluate the one-year outcomes of switching to brolucizumab with and without a loading dose regimen (three monthly injections) in eyes with aflibercept-resistant neovascular age-related macular degeneration (nAMD). Methods. We retrospectively studied nAMD patients who had retinal exudate under bimonthly injections of aflibercept and were switched to brolucizumab from aflibercept. Patients were grouped into intravitreal brolucizumab injection (IVBr) with a loading dose regimen (loading group) and without a loading dose regimen (nonloading group). We assessed the best-corrected visual acuity (BCVA), central retinal thickness (CRT) at the fovea, subfoveal choroidal thickness (SFCT), IVBr status (number of injections and last injection interval), and retinal exudate status on optical coherence tomography. Results. Overall, 52 eyes received ≥1 IVBr; 26 eyes received ≥3 IVBr with 12-month follow-up. A total of 13 eyes in the loading group and 13 eyes in the nonloading group were reviewed. One year after switching, BCVA changed from 0.28 ± 0.25 to 0.19 ± 0.28 in the loading group (P=0.28) and from 0.25 ± 0.20 to 0.23 ± 0.25 in the nonloading group (P=0.92). The mean CRT decreased from 263.6 ± 40.7 µm to 221.7 ± 54.6 µm in the loading group (P=0.03), while it only changed from 244.9 ± 77.2 µm to 221.0 ± 78.7 µm in the nonloading group (P=0.26). Both the loading and nonloading groups achieved 69% dry macula. The number of injections received was significantly higher in the loading group (7.6 ± 0.6 vs. 6.8 ± 0.4, P < 0.001). Two patients (4.2%) developed intraocular inflammation. Conclusion. Switching to brolucizumab from aflibercept for eyes with nAMD with resistance to bimonthly injections of aflibercept is a valuable treatment option with and without the loading regimen. This trial is registered with UMIN000023676.

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High-Dose Brolucizumab for Refractory Neovascular Age-Related Macular Degeneration Resistant to Standard-Dose Brolucizumab

Kim,

Park,

Cho

et al. 2024

Ophthalmol Ther

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Factors Linked to Injection Interval Extension in Eyes with Wet Age-Related Macular Degeneration Switched to Brolucizumab

Cited by 5 publications

References 15 publications

Evaluating photodynamic therapy versus brolucizumab as a second-line treatment for polypoidal choroidal vasculopathy

Evaluating photodynamic therapy versus brolucizumab as a second-line treatment for polypoidal choroidal vasculopathy

The Effect of a Loading Dose Regimen in the Switch to Brolucizumab for Patients with Aflibercept-Resistant nAMD

High-Dose Brolucizumab for Refractory Neovascular Age-Related Macular Degeneration Resistant to Standard-Dose Brolucizumab

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