Brolucizumab for the Treatment of Degenerative Macular Conditions: A Review of Clinical Studies

Karasavvidou, Evdoxia-Maria; Tranos, Paris; Panos, Georgios D

doi:10.2147/dddt.s378450

Cited by 12 publications

(12 citation statements)

References 93 publications

(265 reference statements)

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“…Introduction of new anti-VEGF agents, different regimens of IVI such as pro re nata and treat and extend, and drug delivery systems aim to reduce the frequency of IVI, optimize DME management, and minimize the treatment burden. 17,18 Aflibercept is a well-known effective anti-VEGF in the treatment of DME both in controlled clinical trials and in real-life practice. Aflibercept is superior to bevacizumab anatomically, ranibizumab functionally, and dexamethasone functionally, showing a favorable safety profile.…”

Section: Discussionmentioning

confidence: 99%

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Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series

Elhamaky

2023

European Journal of Ophthalmology

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Purpose To evaluate the effectiveness and safety of intravitreal brolucizumab (IVB) and intravitreal aflibercept (IVA) injections in the management of naive central involved diabetic macular edema (CIDME). Methods This study included 45 treatment-naive eyes with CIDME. A complete ophthalmic examination, including BCVA and SD-OCT was performed. Patients were randomized to (IVB) or (IVA) groups. All participants received a loading phase of three consecutive intravitreal injections, then followed by a personalized treat and extend (T&E) regimen. Results At 12-month follow-up, the mean numbers of injections in IVA and IVB groups were 7.25 ± 0.53 and 6.3 ± 0.45, respectively (P < 0.0001). The IVA group showed a significant increase of the mean BCVA from 0.66 ± 0.15 logMAR (50.9 ± 7.7 letters) to 0.41 ± 0.19 logMAR (63.7 ± 10.8 letters). Mean CFT decreased significantly from 441.2 ± 35.7 μm to 281.3 ± 18.4 μm. The IVB group showed a significant increase of mean BCVA from 0.65 ± 0.16 logMAR (52.1 ± 7.9 letters) to 0.39 ± 0.17 logMAR (65.3 ± 8.7 letters). Mean CFT decreased significantly from 437.2 ± 41.9 μm to 275.5 ± 21.7 μm. No significant difference between both groups in terms of the vision improvement and the reduction of CFT was reported, whereas a statistical difference was observed in terms of intravitreal injections (IVI) numbers. No ocular complications were reported. Conclusions This case series highlights the effectiveness of both brolucizumab and aflibercept in the treatment of CIDME with a lower frequency of injection in brolucizumab group lowering the burden of IVI in this cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series

Elhamaky

2023

European Journal of Ophthalmology

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“…The most common adverse effects in clinical trials were conjunctival hemorrhage, eye pain, and hyperemia, which were mild in intensity and resolved within a few days without treatment 101 . It is currently in phase III clinical investigations to treat diabetic retinopathy and AMD 102 .…”

Section: Brolucizumabmentioning

confidence: 99%

Monoclonal Antibodies: A Therapeutic Option for the Treatment of Ophthalmic Diseases of the Eye Posterior Segment

et al. 2022

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The eye is an organ that allows us to observe the outside world. Pathologies of the eye's posterior segment, such as glaucoma, macular degeneration, diabetic retinopathy, uveitis, and retinoblastoma, cause vision loss. Traditional treatments consist of applying topical medications that do not penetrate properly or using high doses that generate adverse effects. Different laser surgeries stop the pathology's progression but do not allow visual improvement. So, an alternative is to use monoclonal antibodies, proteins produced by different processes that selectively bind to metabolites associated with diseases, reducing the adverse effects of traditional treatments and improving the application of the drug in the area. The two main molecular targets are TNF (adalimumab, infliximab, and certolizumab pegol) and VEGF (bevacizumab and ranibizumab); other possibilities are under investigation.

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“…The aim of AMD treatment is to reduce vision loss and optimize visionrelated quality of life; therefore, anti-VEGF intravitreal treatment has widely been accepted as the first-line therapy for patients with macular NV (MNV) [5]. Different anti-VEGF drugs have been used in order to antagonize the role of the VEGF and reduce exudation caused by MNV [6][7][8]. Among all, it is relevant the role of a relatively new anti-VEGF agent, brolucizumab (Beovu; Novartis, East Hanover, NJ, USA), whose efficacy in nAMD has yet to be demonstrated in HAWK and HARRIER phase 3 clinical trials and different real-world studies [9,10].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up of Brolucizumab in Macular Neovascularization

Ruggeri,

Toto,

D'Aloisio

et al. 2023

Ophthalmic Res

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Introduction: The aim of the study was to evaluate functional and anatomical changes in type 1 and type 2 naïve macular neovascularization (MNV) patients treated with brolucizumab injections up to 1 year of treatment (week 48). Methods: Thirty-eight eyes of 38 patients with active MNV were enrolled at the Ophthalmology Clinic of the University “G. d’Annunzio,” Chieti-Pescara, Italy. All patients were scheduled for brolucizumab intravitreal injections as per label, according to the standard HAWK and HARRIER trials guidelines. Enrolled patients underwent complete ophthalmic evaluation, including optical coherence tomography (OCT) and OCT angiography. All measurements were evaluated at baseline and then monthly up to week 48. The main outcome measures were changes in best-corrected visual acuity (BCVA); central macular thickness (CMT); subfoveal choroidal thickness (SCT); pigment epithelial detachment presence and maximum height (PEDMH); intraretinal fluid (IRF) presence, subfoveal subretinal fluid (SSRF) presence and maximum height, macular atrophy area, and neovascular membrane flow area in the slab extending from the outer retina to choriocapillaris (ORCC flow). Results: CMT and BCVA significantly changed in both groups over time. ORCC flow and SCT significantly reduced in both groups over time. Atrophy areas increased from 0 to 0.17 mm2 and from 0 to 0.23 mm2 in type 1 MNV and type 2 MNV patients, respectively. PEDMH reduced in type 1 MNV from 138 μm at T0 to 96 μm at T5. Changes in fluids were noted, with SSRF thickness reduction and IRF changes in both groups. Conclusion: Our one-year results of treatment confirm brolucizumab to be efficient and safe in both type 1 and type 2 MNV patients, proposing novel OCT parameters as possible biomarkers of treatment.

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Brolucizumab for the Treatment of Degenerative Macular Conditions: A Review of Clinical Studies

Cited by 12 publications

References 93 publications

Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series

Comparison between intravitreal brolucizumab and aflibercept in the treatment-naive central involved diabetic macular edema: One-year real-life case series

Monoclonal Antibodies: A Therapeutic Option for the Treatment of Ophthalmic Diseases of the Eye Posterior Segment

Long-Term Follow-Up of Brolucizumab in Macular Neovascularization

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