Incidence of adverse events after loading phase of the brolucizumab therapy of neovascular AMD: Real-life evidence in the Czech Republic
| Authors | |
|---|---|
| Year of publication | 2023 |
| Type | Article in Periodical |
| Magazine / Source | European Journal of Ophthalmology |
| MU Faculty or unit | |
| Citation | |
| Web | https://journals.sagepub.com/doi/10.1177/11206721221132619 |
| Doi | http://dx.doi.org/10.1177/11206721221132619 |
| Keywords | anti-VEGF therapy; brolucizumab; neovascular age-related macular degeneration; real-life practice; adverse event; switch |
| Description | Aim To evaluate the incidence of ocular adverse events after loading phase of the brolucizumab therapy in patients with neovascular age-related macular degeneration (nAMD) in real-life clinical practice - in treatment-naive patients and in patients after switching from another anti-VEGF agent. Another aim was to evaluate treatment outcomes in patients with adverse events. Methods This is a multicentre, retrospective, observational study from 16 application centres in the Czech Republic. Patients diagnosed with nAMD were treated with brolucizumab in a fixed regimen of loading phase (3 injections administered at one-month intervals) and the mean follow-up period was 120 +/- 10 days after the first injection. The incidence of adverse events and the development of best corrected visual acuity (BCVA) and central retinal thickness (CRT) in patients with complications were evaluated. A total of 1,098 eyes were followed up, of which 783 were treatment-naive and 315 eyes were after switching from another anti-VEGF agent. Results Adverse events were recorded in 42 eyes (3.83%), of which 30 eyes were treatment-naive (2.7%) and 12 eyes were post-switch (1.09%). The mean baseline BCVA +/- SD was 56.7 +/- 10.7 ETDRS chart letters in the group of patients with adverse events, 58.8 +/- 10.1 letters in treatment-naive patients, and 51.4 +/- 10.2 letters in patients after switch from another anti-VEGF agent. The mean baseline CRT +/- SD was 432.2 +/- 154.7 mu m, being 435.8 +/- 137.3 mu m in treatment-naive patients and 424.5 +/- 186.6 mu m in patients after switch from another anti-VEGF agent. At the end of the follow-up, the mean BCVA +/- SD was 53.4 +/- 9.5 ETDRS charts letters in patients with adverse events, 55.6 +/- 10 letters in treatment-naive patients, and 47.6 +/- 10 letters in patients after switching from another anti-VEGF agent. The mean CRT +/- SD at the end of the follow-up was 300.7 +/- 115.7 mu m in the total patient cohort, 285.2 +/- 78.8 mu m in treatment-naive patients and 334.5 +/- 165.4 mu m in patients after switching from another anti-VEGF agent. Conclusion We observed the development of adverse events in the form of intraocular inflammation or vasculitis with subsequent decrease in BCVA in 3.83% of cases after loading phase of the brolucizumab therapy. The decrease in BCVA was reversible in most cases after initiation of anti-inflammatory steroid treatment. From a functional and morphological point of view, we did not demonstrate any statistically significant difference between the groups of treatment-naive patients and patients after switching from another anti-VEGF agent. |