One-Year and 18-Month Outcomes in nAMD Patient Eyes Switched to Brolucizumab Alone versus to Brolucizumab Alternating with Other Anti-VEGF Agents

Joseph M Coney; Jasmyne E McCoy; Samriddhi Buxy Sinha; Nina Sonbolian; Lujia Zhou; Thomas P Hull; Shawn A Lewis; David G Miller; Michael A Novak; Scott D Pendergast; Hang Pham; Sean M Platt; Llewelyn J Rao; Jerome P Schartman; Lawrence J Singerman; Richard Donkor; Margaret Fink; Ryan Zubricky; Helene Karcher

doi:10.2147/OPTH.S432957

One-Year and 18-Month Outcomes in nAMD Patient Eyes Switched to Brolucizumab Alone versus to Brolucizumab Alternating with Other Anti-VEGF Agents

Clin Ophthalmol. 2023 Nov 23:17:3601-3611. doi: 10.2147/OPTH.S432957. eCollection 2023.

Authors

Joseph M Coney¹, Jasmyne E McCoy¹, Samriddhi Buxy Sinha², Nina Sonbolian², Lujia Zhou³, Thomas P Hull¹, Shawn A Lewis¹, David G Miller¹, Michael A Novak¹, Scott D Pendergast¹, Hang Pham¹, Sean M Platt¹, Llewelyn J Rao¹, Jerome P Schartman¹, Lawrence J Singerman¹, Richard Donkor¹, Margaret Fink¹, Ryan Zubricky⁴, Helene Karcher²

Affiliations

¹ Retina Associates of Cleveland Inc, Beachwood, OH, USA.
² Novartis Pharma AG, Basel, Switzerland.
³ KMK Consulting, Morristown, NJ, USA.
⁴ Geisinger Eye Institute, Danville, PA, USA.

Abstract

Objective: Retrospective, real-world study to evaluate visual acuity (VA), anti-vascular endothelial growth factor (anti-VEGF) injection intervals, and central macular thickness (CMT) in neovascular age-related macular degeneration (nAMD) eyes switched to brolucizumab only or to brolucizumab alternating with another anti-VEGF.

Methods: The overall study population comprised eyes that were given ≥1 brolucizumab injection between 1 October 2019 and 30 November 2021. The brolucizumab-only (BRO) cohort consisted of prior anti-VEGF-treated eyes treated exclusively with ≥3 brolucizumab injections over ≥12 or ≥18 months; the alternating brolucizumab (ALT) cohort comprised prior anti-VEGF-treated eyes treated with ≥2 brolucizumab injections and ≥1 other anti-VEGF over ≥12 or ≥18 months.

Results: A total of 482 eyes received ≥1 brolucizumab injection during the study period. Mean VA changes from baseline were -1.1±15.1 letters (BRO cohort; n = 174) and 1.3±13.0 letters (ALT cohort; n = 47) at Month 12, and 0.0±13.5 letters (BRO cohort; n = 95) and -7.3±17.2 letters (ALT cohort; n = 29) at Month 18. Mean changes in injection intervals were +26.9±48.1 days (BRO cohort) and +11.1±17.3 days (ALT cohort) at Month 12 and +36.3±52.3 days (BRO cohort) and +14.0±19.9 days (ALT cohort) at Month 18. Mean changes in CMT were -35.2±108.1 μm (BRO cohort) and -31.5±91.2 μm (ALT cohort) at Month 12 and -38.9±75.0 μm (BRO cohort) and -9.0±59.9 μm (ALT cohort) at Month 18. Intraocular inflammation-related adverse events were recorded in 22/482 (4.6%) eyes.

Conclusion: Treatment with either brolucizumab alone or brolucizumab alternating with another anti-VEGF can preserve vision, reduce CMT, and extend anti-VEGF injection intervals in patients with nAMD.

Keywords: 12-month outcomes; 18-month outcomes; alternating anti-VEGF treatments; brolucizumab; neovascular age-related macular degeneration; wet age-related macular degeneration.

Grants and funding

Financial support was provided by Novartis Pharma AG (Basel, Switzerland). The sponsor or funding organization participated in the design of the study; management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript.