Switching to brolucizumab from aflibercept in age-related macular degeneration with type 1 macular neovascularization and polypoidal choroidal vasculopathy: an 18-month follow-up study

Ueda-Consolvo, Tomoko; Tanigichi, Aya; Numata, Ayaka; Oiwake, Toshihiko; Nakamura, Tomoko; Ishida, M.; Yanagisawa, Shuichiro; Hayashi, Atsushi

doi:10.1007/s00417-022-05793-5

Cited by 11 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Real-world studies focusing on PCV refractory to previous anti-VEGF treatment showed significant fluid reduction but non-significant improvement in BCVA after switching to brolucizumab, which is consistent with our findings [ 19 , 20 ]. The regression rate of polypoidal lesions was reported up to 78.9% after three monthly injections of brolucizumab in treatment-naïve PCV and 26.7% at 18 months in recalcitrant PCV [ 20 , 21 ]. However, in the present study, it is not possible to evaluate the effect on polyp regression as ICGA was not performed after switching to brolucizumab.…”

Section: Discussionsupporting

confidence: 92%

Brolucizumab in recalcitrant neovascular age-related macular degeneration–real-world data in Chinese population

Weng,

Chi,

Lin

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

This retrospective study aimed to determine the short-term efficacy and safety of brolucizumab treatment for recalcitrant neovascular age-related macular degeneration (nAMD) in a real-world setting in Taiwan. Recalcitrant nAMD patients who were treated with brolucizumab from November 2021 to August 2022 at Taipei Veterans General Hospital were included. Patients were followed for 3 months after switching to brolucizumab. The primary outcomes were changes in mean best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to the third month. The secondary outcomes included the incidence of intraocular inflammation (IOI), proportion of patients with subretinal and intraretinal fluid (SRF and IRF), and change in pigment epithelial detachment (PED) height from baseline to the third month. The significance level was considered as p < .05 in all tests. A total of 38 patients (40 eyes) with a mean (±SD) age of 76.3 (±10.84) years were included. The baseline BCVA was 0.92±0.64 logMAR, and the CRT and PED height were 329.0±171.18 and 189.8±114.94 um, respectively. The patients had a significant reduction in CRT and resolution of IRF and SRF from baseline to the third month. There were numerical improvements in mean BCVA and PED height, but they were not significant. The percentages of achieving at least 0.1, 0.2, and 0.3 logMAR (equivalent to 5, 10, 15 ETDRS letters) visual gain were 50%, 37.5%, and 30%, respectively, during the first 3 months of follow-up. No IOI occurred in these patients. This study demonstrated that brolucizumab had good short-term structural and functional efficacy in recalcitrant nAMD patients.

show abstract

Section: Discussionsupporting

confidence: 92%

Brolucizumab in recalcitrant neovascular age-related macular degeneration–real-world data in Chinese population

Weng,

Chi,

Lin

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Although study design, treatment regimen, and study duration were different, several studies have investigated the efficacy of brolucizumab for persistent neovascular AMD [46][47][48][49][50][51][52][53][54]. Recently, Ueda-Consolvo et al reported an 18-month follow-up study of switching to brolucizumab from aflibercept in 42 eyes with exudative AMD [50]. They reported that treatment intervals were significantly extended from 7.4 ± 1.4 weeks to 11.6 ± 2.6 weeks for type 1 macular neovascularization and from 6.9 ± 1.3 weeks to 11.7 ± 3.1 weeks for polypoidal choroidal vasculopathy.…”

Section: Discussionmentioning

confidence: 99%

A Treat-and-Extend Regimen of Intravitreal Brolucizumab for Exudative Age-Related Macular Degeneration Refractory to Aflibercept: A 12-Month Result

et al. 2023

View full text Add to dashboard Cite

We aimed to investigate whether a treat-and-extend regimen of intravitreal brolucizumab (6.0 mg/0.05 mL) is effective for eyes with exudative age-related macular degeneration (AMD) refractory to aflibercept for 12 months. Sixty eyes from 56 patients receiving brolucizumab for exudative AMD refractory to aflibercept were included. Patients received a mean of 30.1 aflibercept administrations for a mean 67.9-month follow-up. All patients exhibited exudation on optical coherence tomography (OCT) despite regular 4–8 weeks of aflibercept administration. Visit 1 was scheduled at the same interval from the last aflibercept injection to the baseline. The treatment interval was extended or shortened by 1–2 weeks depending on the presence or absence of exudation on OCT. After switching to brolucizumab, the follow-up interval significantly extended at 12 months (before switching: 7.6 ± 3.8 weeks vs. at 12 months: 12.1 ± 6.2 weeks, p = 1.3 × 10−7). Forty-three percent of the eyes achieved a dry macula at 12 months after switching. However, the best-corrected visual acuity did not improve at any visit. Morphologically, the central retinal thickness and subfoveal choroidal thickness significantly decreased from baseline at 12 months (p = 3.6 × 10−3 and 1.0 × 10−3, respectively). Switching to brolucizumab can be considered to extend the treatment interval in eyes with exudative AMD refractory to aflibercept.

show abstract

“…B rolucizumab is a single-chain antibody fragment against vascular endothelial growth factor (VEGF) that some countries have approved for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). 1,2 Brolucizumab seems to offer better fluid control than aflibercept [3][4][5][6][7][8] ; however, it is also associated with a higher incidence of intraocular inflammation (IOI), including serious adverse events such as retinal vasculitis (RV) and retinal vascular occlusion (RO), compared with other anti-VEGF agents. 9,10 Retinal vasculitis/RO can potentially lead to severe vision loss, even when treated as early as possible.…”

mentioning

confidence: 99%

“…Initially, a post hoc analysis suggested that the rate of IOI may be higher in Japanese people than in other ethnic groups. 13 There have also been numerous small-scale sporadic studies reporting the incidence of IOI in Japan, 6,8,[14][15][16][17][18][19] but these were too small to draw meaningful conclusions about the incidence of IOI and its risk factors.…”

mentioning

confidence: 99%

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

Inoda,

Takahashi,

Maruyama-Inoue

et al. 2023

Retina

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Switching to brolucizumab from aflibercept in age-related macular degeneration with type 1 macular neovascularization and polypoidal choroidal vasculopathy: an 18-month follow-up study

Cited by 11 publications

References 30 publications

Brolucizumab in recalcitrant neovascular age-related macular degeneration–real-world data in Chinese population

Brolucizumab in recalcitrant neovascular age-related macular degeneration–real-world data in Chinese population

A Treat-and-Extend Regimen of Intravitreal Brolucizumab for Exudative Age-Related Macular Degeneration Refractory to Aflibercept: A 12-Month Result

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

Contact Info

Product

Resources

About