Incidence and Risk factors of Intraocular Inflammation after Brolucizumab Treatment in Japan: A Multicenter AMD Study

Abstract

Purpose: To investigate the incidence of intraocular inflammation (IOI) and its risk factors following intravitreal injections of brolucizumab for neovascular age-related macular degeneration (nAMD) in Japan. Methods: A total of 1351 Japanese consecutive patients with nAMD who were treated with brolucizumab from May 2020 to May 2022 at 14 institutions were examined. The variables analyzed were the number of brolucizumab injections, time to onset of IOI, and risk factors. Results: IOI developed in 152 eyes (11.3%). Retinal vasculitis and/or retinal occlusion (RV and/or RO) occurred in 53 eyes (3.9%). Ninety-four patients received bilaterally, bilateral IOI occurred in 5 patients (5.3%). Sixteen eyes (1.2%) had irreversible visual acuity loss and nine eyes (0.67%) had visual loss of 3 lines or more due to RV and/or RO. The cumulative IOI incidence was 4.5%, 10.3%, and 12.2% at 30, 180, and 365 days (1-year), respectively. Prior history of IOI (including RV) and/or RO (odds ratio[OR], 5.41; P = 0.0075) and female sex (OR, 1.99; P = 0.0004) were significantly associated with IOI onset. Conclusion: The 1-year cumulative incidence of IOI in Japanese nAMD patients treated with brolucizumab was 12.2%. Prior history of IOI (including RV) and/or RO and female sex were significant risk factors.

One-year visual and anatomical outcomes of intravitreal faricimab injection for neovascular age-related macular degeneration after prior brolucizumab treatment

“…Reports of its efficacy in the real-world setting have shown relatively favorable results compared with aflibercept for treating subretinal pigment epithelial lesions and reducing choroidal thickness 3 – 7 . However, several post-marketing studies have reported higher than expected rates of intraocular inflammation following intravitreal brolucizumab (IVBr) injection, including cases of occlusive retinal vasculitis 8 – 10 , prompting increased clinical caution surrounding the use of IVBr.…”

“…† One patient could pause injections and switch to a pro re nata regimen because no exudative change was observed for over 20 weeks, and this patient was excluded from this result. ‡ Two eyes from a patient were monitored without treatment because no exudative change was observed for over8 weeks, and this patient is excluded from this result. NA Vol.…”