Results from two large, phase III studies (HAWK and HARRIER) have found brolucizumab 6 mg (Novartis) produced better anatomical outcomes than aflibercept-in terms of retinal thickness, intraretinal fluid (IRF), and/or subretinal fluid (SRF) status and in sub-retinal pigment epithelial (RPE) fluid status, said Pravin U. Dugel, MD.
The HAWK and HARRIER studies are the first that "individualize" treatment, explained Dr. Dugel, of Retinal Consultants of Arizona, Phoenix.
"We don't necessarily use the branded anti-vascular endothelial growth factor (VEGF) drugs on-label-we treat based on what the disease itself dictates," he said.
Some patients will require very intensive treatment, while others will not, Dr. Dugel said.
"We do not know how to differentiate them; we don't have a genetic test to follow or biomarkers to follow," he said.
HAWK and HARRIER are (to date) the only phase III studies that attempt to mimic real-world treatment regimens, Dr. Dugel noted.
Dr. Dugel is a consultant and investigator for Novartis and reports receiving honoraria from Novartis.
1. Dugel PU, Jaffe GJ, Sallstig P, et al. Brolucizumab versus aflibercept in participants with neovascular age-related macular degeneration: A randomized trial. Ophthalmology. 2017;124:1296-1304. doi: 10.1016/j.ophtha.2017.03.057