KESTREL & KITE: Reports on brolucizumab in treatment of DME

At ASRS, David Brown, MD, reported positive results at the head-to-head endpoints of KESTREL and KITE, but with continuing concerns about inflammation.

On October 9, 2021, David Brown, MD, presented his talk entitled, “Brolucizumab for the Treatment of Visual Impairment Due to Diabetic Macular Edema: 52-Week Results From the KESTREL and KITE Studies,” at the 39th Annual ASRS Scientific Meeting.

Dr. David Brown practices at the Retina Consultants of Texas.

Video transcript

David Brown, MD: So basically, I am from Texas. South Texas in particular and all over the country, there's just a scourge of diabetes with increasing diabetic retinopathy. We've gotten, we’ve come a long ways: we went from where diabetes caused blindness, where we've kind of saved things, have slowed things down with laser. Now with anti-VEGF, we've really saved a lot of people, but there's still a lot of patients that have so much demand, so much VEGF. We're looking for stronger, better molecules.

What I presented today was KESTREL KITE; very strong molecule, brolucizumab, two very large trials around the world, KESTREL and KITE. What we demonstrated was that compared head-to-head with Eylea, our current best drug, really got equal visual acuity but we saw a better anatomic visual results. In other words, the anatomy in KITE, it was statistically significant better drying, we also had better intraretinal fluid and subretinal fluid at the head-to-head endpoints.

What's the rub? In this drug, we've seen inflammation, and particularly in macular degeneration, we were very concerned in diabetes it was going to be worse. It actually looked a little better. And in KITE, the amount of inflammation was the same between brolucizumab and aflibercept. Unfortunately, we did still see some retinal vasculitis in KESTREL, with three patients in the three milligram arm and one patient and six milligram arm. That patient got lucky and got back to baseline, but it's not perfect.

And so in summary, we have a drug that the risk-benefit ratio looks better than I thought it would in diabetes; I was concerned it was going to be worse. Certainly in these hard-to-treat patients, it's going to be a conversation of is the risk-benefit ratio worth it to try to get better results in these patients we can’t dry out otherwise.

The American Society of Retina Specialists (ASRS) hosted its 39th Annual Scientific Meeting from October 8-12, 2021, at the JW Marriott San Antonio Hill Country Resort and Spa in San Antonio, Texas.

According to ASRS, its 2021 scientific program offered attendees innovations in retina science, clinical practice, and surgery with 148 papers, 165 posters, 46 papers on demand, and 69 films, as well as a wide range of networking opportunities and the chance to exchange ideas and perspectives with peers.

Related Content: Additional ASRS 2021 Content | Conference Coverage | Ophthalmology