Brolucizumab for neovascular age-related macular degeneration holds up in real world

The use of brolucizumab for the treatment of patients with neovascular age-related macular degeneration (nAMD) in the real-world setting appears to be effective and safe, consistent with data from pivotal trials, as reported in a study.

Researchers conducted a systematic review of real-world studies to summarize the efficacy and safety data on brolucizumab in patients with nAMD. They searched multiple online databases for relevant studies and identified 26 studies involving a total of 2,907 brolucizumab-treated eyes for inclusion in the review.

Data were obtained for treatment-naïve eyes (six studies), eyes switched to brolucizumab from other antivascular endothelial growth factor (anti-VEGF; 16 studies), and/or treatment-naïve and treatment-switched eyes combined (eight studies). Follow-up time points ranged from 4 weeks to 1 year after brolucizumab initiation.

In terms of best-corrected visual acuity (BCVA), brolucizumab treatment produced significant improvements in four of six studies in treatment-naïve eyes (mean BCVA improvement range, 3.7–11.9 Early Treatment Diabetic Retinopathy Study [ETDRS] letters) and in three of 12 studies in brolucizumab-switched eyes (range, 9.0–15 ETDRS letters; p<0.05 for all).

For central subfield thickness (CST), brolucizumab treatment yielded favourable outcomes in all six studies in treatment-naïve eyes (mean CST improvement range, −113.4 to −150.1 μm) and in eight of 11 studies in brolucizumab-switched eyes (range, −26 to −185.7 μm; p<0.05 for all).

The 14 studies with data on intraretinal, subretinal, and/or total fluid outcomes all reported improvements following brolucizumab initiation. Moreover, the four studies that compared treatment intervals showed that switching to brolucizumab prolonged the interval between injections.

The frequency of intraocular inflammation ranged from 0 percent to 19 percent.