Risk Factors for Intraocular Inflammation After Brolucizumab Treatment

Baumal, Caroline R.

doi:10.1001/jamaophthalmol.2021.4586

Cited by 8 publications

(2 citation statements)

References 8 publications

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“…These show an incidence of approximately 2.4% for IOI and/or vascular occlusion just after the launch of brolucizumab in the USA and during a median follow‐up time of approximately 3 months (Khanani, Zarbin, et al, 2022). Physicians are likely since then to have gained increased awareness of these potential risks and the importance of early, intensive management (Baumal, 2022; Baumal et al, 2021), with reports of positive outcomes in such patients (Khoramnia et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of brolucizumab in age‐related macular degeneration: A systematic review of real‐world studies

Baumal

Sørensen

Karcher

et al. 2022

Acta Ophthalmologica

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Intravitreally injected anti-vascular endothelial growth factor (anti-VEGF) agents are first-line treatment for neovascular age-related macular degeneration (nAMD).Phase 3 trials demonstrated non-inferiority of anti-VEGF therapy with brolucizumab compared with aflibercept in best corrected visual acuity (BCVA) gains, with superior anatomical outcomes after brolucizumab. The purpose of the review was to summarize real-world efficacy and safety data on brolucizumab in patients with nAMD. The review protocol was registered with PROSPERO (ID: CRD42021290530). We conducted systematic searches in Embase, Medline and key ophthalmology congress websites (19 October 2021). Original reports of efficacy and/or safety in patients receiving brolucizumab to treat nAMD in clinical practice were eligible. The descriptive summary includes reports describing at least 10 brolucizumab-treated eyes. In total, 2907 brolucizumab-treated eyes from 26 studies were included. Outcomes were available for treatment-naive eyes (six studies), eyes switched to brolucizumab from other anti-VEGFs (16 studies), and/ or treatment-naive and switch eyes combined (eight studies). Follow-up time points ranged from 4 weeks to 1 year post-brolucizumab initiation. For BCVA, significant improvements compared with brolucizumab initiation were reported in four of six studies in treatment-naive eyes (mean BCVA improvement, range: +3.7 to +11.9 EarlyTreatment Diabetic Retinopathy Study [ETDRS] letters) and in three of 12 studies in switch eyes (range: +9.0 to +15 ETDRS letters) (all p < 0.05); remaining studies reported no significant post-brolucizumab BCVA changes. For central subfield thickness (CST), improvements post-brolucizumab initiation were reported in all six studies in treatment-naive eyes (mean CST improvement, range: −113.4 to −150.1 μm) and in eight of 11 studies in switch eyes (range: −26 to −185.7 μm) (all p < 0.05). The 14 studies reporting on intraretinal, subretinal and/or total fluid observed improvements post-brolucizumab initiation. The four studies comparing treatment intervals observed extension of the interval between injections after switching to brolucizumab from other anti-VEGFs. Incidence of intraocular inflammation ranged from 0% to 19%. In conclusion, real-world efficacy and safety data concur with brolucizumab pivotal trials. Additionally, reduction of disease activity in anti-VEGF switch eyes was demonstrated by fluid reduction and/or visual acuity gain, along with prolongation of the interval between injections.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of brolucizumab in age‐related macular degeneration: A systematic review of real‐world studies

Baumal

Sørensen

Karcher

et al. 2022

Acta Ophthalmologica

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“…All the trials with the monthly regimen after the result of the MERLIN trial were cancelled. 29,30 KESTREL and KITE studies did not reveal any safety concerns with brolucizumab over aflibercept. The incidence of intraocular inflammation in the KESTREL and KITE studies was 1.1%-2.2% for brolucizumab 6 mg as compared to 1.7%-2.1% for aflibercept.…”

Section: Discussionmentioning

confidence: 94%

Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series

Elhamaky

2023

European Journal of Ophthalmology

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Purpose To evaluate the effectiveness and safety of intravitreal brolucizumab (IVB) and intravitreal aflibercept (IVA) injections in the management of naive central involved diabetic macular edema (CIDME). Methods This study included 45 treatment-naive eyes with CIDME. A complete ophthalmic examination, including BCVA and SD-OCT was performed. Patients were randomized to (IVB) or (IVA) groups. All participants received a loading phase of three consecutive intravitreal injections, then followed by a personalized treat and extend (T&E) regimen. Results At 12-month follow-up, the mean numbers of injections in IVA and IVB groups were 7.25 ± 0.53 and 6.3 ± 0.45, respectively (P < 0.0001). The IVA group showed a significant increase of the mean BCVA from 0.66 ± 0.15 logMAR (50.9 ± 7.7 letters) to 0.41 ± 0.19 logMAR (63.7 ± 10.8 letters). Mean CFT decreased significantly from 441.2 ± 35.7 μm to 281.3 ± 18.4 μm. The IVB group showed a significant increase of mean BCVA from 0.65 ± 0.16 logMAR (52.1 ± 7.9 letters) to 0.39 ± 0.17 logMAR (65.3 ± 8.7 letters). Mean CFT decreased significantly from 437.2 ± 41.9 μm to 275.5 ± 21.7 μm. No significant difference between both groups in terms of the vision improvement and the reduction of CFT was reported, whereas a statistical difference was observed in terms of intravitreal injections (IVI) numbers. No ocular complications were reported. Conclusions This case series highlights the effectiveness of both brolucizumab and aflibercept in the treatment of CIDME with a lower frequency of injection in brolucizumab group lowering the burden of IVI in this cohort.

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Neovaskuläre altersabhängige Makuladegeneration

Liegl

2024

Springer Reference Medizin

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Risk Factors for Intraocular Inflammation After Brolucizumab Treatment

Abstract: 27. Sekeroglu MA, Kilinc Hekimsoy H, Horozoglu Ceran T, Doguizi S. Treatment of neovascular age related macular degeneration during COVID-19 pandemic: the short term consequences of unintended lapses. Eur J Ophthalmol. 2021; 11206721211010613.

Cited by 8 publications

References 8 publications

Efficacy and safety of brolucizumab in age‐related macular degeneration: A systematic review of real‐world studies

Efficacy and safety of brolucizumab in age‐related macular degeneration: A systematic review of real‐world studies

Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series

Neovaskuläre altersabhängige Makuladegeneration

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