Abstract
Purpose :
Recent clinical trials have explored the efficacy of intravitreal brolucizumab (IVB) for wet AMD in treatment-naïve patients, but little is known about its use in treatment-experienced patients. The purpose of this study is to evaluate patient response to IVB in a real-life clinical setting with a focus on successful extension of treatment interval while maintaining visual acuity (VA) and central foveal thickness (CFT).
Methods :
This was a retrospective, single-center study. We included 144 patients with wet AMD who received their first treatment of IVB between 11/1/20 and 4/20/20, and these patients were followed through 12/4/20. All patients were previously treated with intravitreal anti-VEGF. Using the treat and extend regimen, patients were observed closely to ensure that they achieved optimal treatment intervals. All patients underwent eye examinations at each visit and optical coherence tomography imaging at least every other visit. Key outcome measures were VA, CFT, and treatment interval.
Results :
144 eyes that received IVB for wet AMD were included in this study (64 men and 80 women, average age 77.56±11.84). Prior to the study period, patients had an average baseline logMAR VA of 0.6050±0.4635, average baseline CFT of 281.84±81.63 µm, and average baseline treatment interval of 33.93±9.85 days. During the study period, patients received an average of 4.37±1.74 (range 1-8) treatments, with 84.0% of the population having received 3 or more treatments. Changes in VA and CFT from baseline to final treatment were of statistical nonsignificance, but average treatment interval was extended from 33.76 days to 60.37 days (p<.001). Average baseline treatment interval increased significantly to 43.99±20.17, 42.69±15.05, 64.60±16.75, 61.24±11.83, 62.48±11.23, and 52.70±14.48 after 1, 2, 3, 4, 5, and 6 treatments, respectively (p<0.001). 106 (81.54%) patients extended their treatment intervals by at least seven days, 21 (16.15%) maintained their previous interval, and 3 (2.31%) tightened their previous intervals by at least seven days. 99 (76.15%) patients achieved an interval of 56 days or longer.
Conclusions :
The results of this study showed that IVB is a promising treatment option for patients with suboptimal response to other anti-VEGF agents. Our study cohort maintained VA and CFT within one standard deviation of baseline while, on average, extending their treatment intervals and therefore reducing treatment burden.
This is a 2021 ARVO Annual Meeting abstract.