June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Real World Efficacy and Safety of Brolucizumab in Neovascular AMD: The REBEL Study
Author Affiliations & Notes
  • Aamir Abdul Aziz
    Sierra Eye Associates, Reno, Nevada, United States
  • Arshad M. Khanani
    Sierra Eye Associates, Reno, Nevada, United States
    University of Nevada Reno, Reno, Nevada, United States
  • Nikolas London
    Retina Consultants San Diego, Poway, California, United States
  • Molly M. Hagen
    University of Nevada Reno, Reno, Nevada, United States
  • Carl J Danzig
    Rand Eye Institute, Deerfield, Florida, United States
  • Amol D Kulkarni
    SSM Health Dean Medical Group, Madison, Wisconsin, United States
  • Veeral S Sheth
    University Retina, Chicago, Illinois, United States
  • Chirag D Jhaveri
    Retina Consultants of Austin, Austin, Texas, United States
  • David Aaron Eichenbaum
    Retina Vitreous Associates of Florida, Tampa, Florida, United States
  • Michael Singer
    Medical Center Ophthalmology Associates, San Antonio, Texas, United States
  • Footnotes
    Commercial Relationships   Aamir Aziz, None; Arshad Khanani, Adverum (F), Adverum (C), Allergan (F), Allergan (C), Bausch and Lomb (C), Chengdu Kanghong (F), Chengdu Kanghong (C), DORC (C), Eyepoint Pharmaceuticals (C), Gemini Therapeutics (F), Gemini Therapeutics (C), Genentech (F), Genentech (C), Gyroscope (C), Hoffman-La Roche (F), IvericBio (F), Kodiak (F), Kodiak (C), Novartis (F), Novartis (C), Opthea (F), Opthea (C), Oxurion (F), Recens Medical (F), Regenxbio (F); Nikolas London, Adverum (F), Allergan (F), Amgen (F), Apellis (F), Bayer (F), Chengdu Kanghong (F), Gemini Therapeutics (F), Genentech (F), Genentech (C), Gyroscope (F), Hoffman-La Roche (F), Ionis (F), Kodiak (F), Novartis (F), Novartis (C), Opthea (F), Optos (F), Outlook (F), Oxurion (F), Regenxbio (F), Regenxbio (C), Sandoz (F); Molly Hagen, None; Carl Danzig, DORC (C), Genentech (C), IvericBio (C), Novartis (C), Regeneron (C); Amol Kulkarni, None; Veeral Sheth, Alimera (C), Alimera Sciences (F), Allergan (F), Chengdu Kanghong (F), DRCR (F), Eyepoint (C), Genentech (C), Genentech (F), Gyroscope (F), Ionis (F), IvericBio (F), NGM Biopharmaceuticals (F), Novartis (C), Novartis (F), Regeneron (F), SalutarisMD (F), SamChungDang (F), Santen (F); Chirag Jhaveri, Novartis (C); David Eichenbaum, Alimera (C), Allergan (C), Apellis (C), Boston Image Reading Center (I), Clearside (I), Clearside (C), DORC (C), DORC (C), Eyepoint (C), Genentech (C), Gyroscope (C), Hemera Biopharmaceuticals (I), IvericBio (C), KKR (C), Kodiak (C), Network Eye (S), Network Eye (I), Notal Vision (C), Novartis (C), RecensMedical (C), Regeneron (C), US Retina (I); Michael Singer, Aerie (C), Aerie (F), Allegro (C), Allegro (F), Allergan (C), Allergan (F), Aviceda (I), DRCR (F), Eyepoint (C), Genentech (C), Genentech (F), Icon (F), Inflammasome (I), Ionis (F), Kalvista (F), Kodiak (C), Kodiak (F), Mallinkrodt (C), Nanoscope (I), Novartis (C), Novartis (F), Opthea (F), Regeneron (C), Santen (C), Spark (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 451. doi:
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    • Get Citation

      Aamir Abdul Aziz, Arshad M. Khanani, Nikolas London, Molly M. Hagen, Carl J Danzig, Amol D Kulkarni, Veeral S Sheth, Chirag D Jhaveri, David Aaron Eichenbaum, Michael Singer; Real World Efficacy and Safety of Brolucizumab in Neovascular AMD: The REBEL Study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):451.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Brolucizumab was FDA approved for the treatment of neovascular age-related macular degeneration (nAMD) in 2019. This multi-center real-world retrospective study evaluated the safety and efficacy of brolucizumab in patients diagnosed with nAMD.

Methods : In this multi-center retrospective study, both treatment-naïve patients and patients switched to brolucizumab from other anti-VEGF agents were evaluated. Information collected included demographics, number of previous treatments or if treatment naïve, ETDRS visual acuity, central retinal thickness (CRT) and changes in pigment epithelial detachments (PED), if applicable. Improvements in PED height and retinal fluid are evaluated as a proportion of patients. Improvements in visual acuity, CRT and PED height are evaluated as averages. Observed and calculated data is reported.

Results : A total of 282 eyes were evaluated after treatment with brolucizumab for nAMD. The mean [SEM] age of patients was 81.2 [0.51] years. The majority of patients were switched from other anti-VEGF agents after persistent disease activity (63.9%), followed by a desire to elongate treatment intervals (32.3%). Patients received an average of 2.4 [0.06] injections. Over half of the patients treated with brolucizumab discontinued the agent (54.4%), with 86% of these doing so out of caution after reports of intraocular inflammation (IOI) or occlusive vasculitis. A total of 14 patients experienced an adverse event: 10 cases of IOI, one case of occlusive vasculitis and 3 cases of pain. In patients who received at least three treatments of brolucizumab, the proportion of patients with intraretinal fluid (IRF), subretinal fluid (SRF), and PEDs decreased, (34.5% to 27.2%), (49.8% to 31.6%), (59.8% to 54.6%), respectively. Improvements in visual acuity (62.4 [0.94] letters to 64.5 [1.25] letters), CRT (312.4 [6.32] mm to 269.8 [7.31] mm) and PED height (236.0 [15.98] mm to 206.7 [12.9] mm) were also calculated.

Conclusions : Brolucizumab demonstrated efficacy in naïve as well as previously treated patients with nAMD through various measures, by achieving improvements in the proportion of patients without IRF, SRF and PEDs, and improving visual acuity, CRT and PED height. Overall, 10 patients had IOI and one patient had occlusive vasculitis. Further studies are needed to continue evaluating real-world safety and efficacy outcomes of patients treated with brolucizumab.

This is a 2021 ARVO Annual Meeting abstract.

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