Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration
Neesurg Mehta,1 Rodney D Fong,1,2 Machelle Wilson,3 Kareem Moussa,1 Parisa Emami-Naeini,1,4 Ala Moshiri,1 Glenn Yiu,1 Susanna S Park1 1Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA; 2University of Nevada, Reno School of Medicine, Reno, NV,...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-02-01
|
| Series: | Clinical Ophthalmology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/real-world-experience-using-intravitreal-brolucizumab-alone-or-in-comb-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1811162864541499392 |
|---|---|
| author | Mehta N Fong RD Wilson M Moussa K Emami-Naeini P Moshiri A Yiu G Park SS |
| author_facet | Mehta N Fong RD Wilson M Moussa K Emami-Naeini P Moshiri A Yiu G Park SS |
| author_sort | Mehta N |
| collection | DOAJ |
| description | Neesurg Mehta,1 Rodney D Fong,1,2 Machelle Wilson,3 Kareem Moussa,1 Parisa Emami-Naeini,1,4 Ala Moshiri,1 Glenn Yiu,1 Susanna S Park1 1Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA; 2University of Nevada, Reno School of Medicine, Reno, NV, USA; 3Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, CA, USA; 4Department of Ophthalmology, Veterans Administration Hospital, Mather, CA, USACorrespondence: Susanna S Park, Department of Ophthalmology & Vision Science, University of California Davis Health, Ernest E. Tschannen Eye Institute, 4860 Y St, Sacramento, CA, 95817, USA, Tel +1 916 734 6074, Fax +1 916 703 5076, Email sscpark@ucdavis.eduPurpose: To evaluate real-world experience using intravitreal brolucizumab (IVBr), alone or in combination with aflibercept, in eyes with neovascular age-related macular degeneration (nAMD) treated previously with other inhibitors of VEGF (anti-VEGF).Methods: This was a retrospective study of all eyes with nAMD treated with IVBr on a treat-and-extend protocol at a single center. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT) at baseline and final visit, and drug-related adverse events were analyzed. Eyes with recurrent macular fluid on IVBr every 8 weeks were treated with a combination therapy alternating between IVBr and aflibercept every month.Results: Among 52 eyes (40 patients) on IVBr, all had been previously treated with other anti-VEGF therapy, with 73% having persistent macular fluid. After a mean follow-up of 46.2± 27.4 weeks on IVBr, the mean treatment interval for intravitreal therapy increased to 8.8± 2.1 weeks on IVBr from a baseline of 6.1± 3.1 weeks (p< 0.001). Macular fluid decreased and BCVA was stable/improved in 61.5% of eyes on IVBr. Ten eyes with increased macular fluid on IVBr monotherapy when extended to every 8 weeks were treated with combination therapy alternating between IVBr and aflibercept every 4 weeks. In these eyes, 80% had improved macular fluid on OCT and 70% stable or improved BCVA after a median follow-up of 53 weeks on combination therapy. Mild intraocular inflammation developed in four eyes, all occurring on IVBr monotherapy, and none had associated vision loss.Conclusion: In the real world, IVBr used to treat eyes with nAMD previously treated with other anti-VEGF therapies appears to be well tolerated and associated with an improvement in macular fluid, stabilization of BCVA, and/or increase in intravitreal treatment interval. Combination therapy alternating between IVBr and aflibercept monthly appears to be well tolerated and can be considered for eyes with macular fluid on IVBr every 8 weeks.Keywords: age-related macular degeneration, aflibercept, anti-VEGF, brolucizumab, intravitreal injection; optical coherence tomography |
| first_indexed | 2024-04-10T06:37:12Z |
| format | Article |
| id | doaj.art-430ed91ce48d4ad092292a55fe6c59ff |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-04-10T06:37:12Z |
| publishDate | 2023-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-430ed91ce48d4ad092292a55fe6c59ff2023-02-28T18:02:43ZengDove Medical PressClinical Ophthalmology1177-54832023-02-01Volume 1765766581903Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular DegenerationMehta NFong RDWilson MMoussa KEmami-Naeini PMoshiri AYiu GPark SSNeesurg Mehta,1 Rodney D Fong,1,2 Machelle Wilson,3 Kareem Moussa,1 Parisa Emami-Naeini,1,4 Ala Moshiri,1 Glenn Yiu,1 Susanna S Park1 1Department of Ophthalmology and Vision Science, University of California Davis Health, Sacramento, CA, USA; 2University of Nevada, Reno School of Medicine, Reno, NV, USA; 3Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, CA, USA; 4Department of Ophthalmology, Veterans Administration Hospital, Mather, CA, USACorrespondence: Susanna S Park, Department of Ophthalmology & Vision Science, University of California Davis Health, Ernest E. Tschannen Eye Institute, 4860 Y St, Sacramento, CA, 95817, USA, Tel +1 916 734 6074, Fax +1 916 703 5076, Email sscpark@ucdavis.eduPurpose: To evaluate real-world experience using intravitreal brolucizumab (IVBr), alone or in combination with aflibercept, in eyes with neovascular age-related macular degeneration (nAMD) treated previously with other inhibitors of VEGF (anti-VEGF).Methods: This was a retrospective study of all eyes with nAMD treated with IVBr on a treat-and-extend protocol at a single center. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT) at baseline and final visit, and drug-related adverse events were analyzed. Eyes with recurrent macular fluid on IVBr every 8 weeks were treated with a combination therapy alternating between IVBr and aflibercept every month.Results: Among 52 eyes (40 patients) on IVBr, all had been previously treated with other anti-VEGF therapy, with 73% having persistent macular fluid. After a mean follow-up of 46.2± 27.4 weeks on IVBr, the mean treatment interval for intravitreal therapy increased to 8.8± 2.1 weeks on IVBr from a baseline of 6.1± 3.1 weeks (p< 0.001). Macular fluid decreased and BCVA was stable/improved in 61.5% of eyes on IVBr. Ten eyes with increased macular fluid on IVBr monotherapy when extended to every 8 weeks were treated with combination therapy alternating between IVBr and aflibercept every 4 weeks. In these eyes, 80% had improved macular fluid on OCT and 70% stable or improved BCVA after a median follow-up of 53 weeks on combination therapy. Mild intraocular inflammation developed in four eyes, all occurring on IVBr monotherapy, and none had associated vision loss.Conclusion: In the real world, IVBr used to treat eyes with nAMD previously treated with other anti-VEGF therapies appears to be well tolerated and associated with an improvement in macular fluid, stabilization of BCVA, and/or increase in intravitreal treatment interval. Combination therapy alternating between IVBr and aflibercept monthly appears to be well tolerated and can be considered for eyes with macular fluid on IVBr every 8 weeks.Keywords: age-related macular degeneration, aflibercept, anti-VEGF, brolucizumab, intravitreal injection; optical coherence tomographyhttps://www.dovepress.com/real-world-experience-using-intravitreal-brolucizumab-alone-or-in-comb-peer-reviewed-fulltext-article-OPTHage-related macular degenerationafliberceptanti-vegfbrolucizumabintravitreal injection. optical coherence tomography |
| spellingShingle | Mehta N Fong RD Wilson M Moussa K Emami-Naeini P Moshiri A Yiu G Park SS Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration Clinical Ophthalmology age-related macular degeneration aflibercept anti-vegf brolucizumab intravitreal injection. optical coherence tomography |
| title | Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration |
| title_full | Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration |
| title_fullStr | Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration |
| title_full_unstemmed | Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration |
| title_short | Real-World Experience Using Intravitreal Brolucizumab Alone or in Combination with Aflibercept in the Management of Neovascular Age-Related Macular Degeneration |
| title_sort | real world experience using intravitreal brolucizumab alone or in combination with aflibercept in the management of neovascular age related macular degeneration |
| topic | age-related macular degeneration aflibercept anti-vegf brolucizumab intravitreal injection. optical coherence tomography |
| url | https://www.dovepress.com/real-world-experience-using-intravitreal-brolucizumab-alone-or-in-comb-peer-reviewed-fulltext-article-OPTH |
| work_keys_str_mv | AT mehtan realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT fongrd realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT wilsonm realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT moussak realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT emaminaeinip realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT moshiria realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT yiug realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration AT parkss realworldexperienceusingintravitrealbrolucizumabaloneorincombinationwithafliberceptinthemanagementofneovascularagerelatedmaculardegeneration |