Study results see brolucizumab as a viable treatment for patients with neovascular age-related macular degeneration (nAMD) refractory to other anti-VEGF drugs.
A clinical retrospective observational study1 conducted at the University Hospital of Leuven, Belgium aimed to report on the real-world use of brolucizumab (Beovu; Novartis). The researchers focused on the efficacy, durability, and safety and evaluated the effects on visual acuity, anatomical efficacy, and progression-free interval duration.
Phase 3 clinical trials of brolucizumab, particularly HAWK and HARRIER, reported a higher occurrence of intra-ocular inflammation (IOI). The researchers in this real-world study closely monitored participants for IOI and other adverse effects to further explore these safety concerns.
The study consisted of a cohort of 17 patients with nAMD (19 eyes) who switched to brolucizumab after an insufficient response to previous anti-VEGF agents. Brolucizumab effectively reduced fluid in different retinal compartments and prolongs the treatment interval in patients with nAMD while maintaining a stable vision.
Brolucizumab was discontinued in 4 eyes due to IOI. In most cases inflammation was mild and well controlled with topical steroids. One eye showed anterior chamber inflammation followed by vitritis that was also well-managed under sub-tenon corticoid injections. None of the patients showed signs of occlusive or non-occlusive vasculitis.
The authors noted that the inflammation occurred within the first 2 injections of brolucizumab in 2 eyes (50%). All patients were screened with meticulous care for the occurrence of IOI and were instructed to urgently return to the clinic in case of clinical symptoms. This allowed the researchers to detect and adequately treat the cases of inflammation at an early stage, supporting close monitoring and patient counselling for signs of IOI when using brolucizumab.
Further research examining the mechanisms behind the increased rate of inflammation as well as additional long-term analyses including larger population samples could provide more useful information regarding the efficacy, safety profile, and durability of brolucizumab.