Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-06-01 Epub Date: 2025-04-18 DOI:10.1007/s40123-025-01141-y

Federico Beretta, Ilaria Zucchiatti, Riccardo Sacconi, Federico Fantaguzzi, Stefano Lingardo, Francesco Bandello, Giuseppe Querques

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引用次数: 0

Abstract

Introduction: To analyze visual and anatomical outcomes in patients switched to brolucizumab and previously treated with other intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for exudative neovascular age-related macular degeneration (nAMD). These outcomes were was assessed in the real-world setting of a tertiary center with a follow-up period of 2 years.

Methods: This retrospective longitudinal study included 29 eyes of 24 patients with exudative nAMD previously treated with at least three injections of another intravitreal anti-VEGF molecule. The eyes were then treated with brolucizumab for at least 24 months following the switch. A pro re nata ("as needed") therapeutic regimen was followed in our clinic between January 2021 and June 2024, during which time clinical and anatomical parameters were evaluated, and possible adverse events were recorded.

Results: After 24 months of treatment with brolucizumab, patients showed a significant reduction in central macular thickness (P = 0.001) and choroidal thickness (P < 0.001). Visual acuity remained stable during the follow-up period. "Poor responders" had longer disease duration and had received more injections before the switch than "good responders." Adverse events included one subretinal hemorrhage and one intraocular inflammation across 302 injections.

Conclusions: Treatment with brolucizumab is effective in patients previously treated with other therapeutic molecules. The best outcomes were achieved in patients who switched therapy to brolucizumab early in their disease. Treatment with brolucizumab in this population demonstrated an acceptable risk profile, with only one intraocular inflammatory event out of 302 intravitreal injections.

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三级中心玻璃体内Brolucizumab转换治疗渗出性新生血管性老年性黄斑变性的两年实际经验

本研究旨在分析先前使用其他玻璃体内抗血管内皮生长因子（anti-VEGF）药物治疗渗出性新生血管性年龄相关性黄斑变性（nAMD）的患者切换到brolucizumab治疗的视觉和解剖学结果。这些结果是在一个三级中心的现实环境中进行的，随访期为2年。方法：这项回顾性纵向研究包括24例渗出性nAMD患者的29只眼睛，此前曾接受过至少三次玻璃体内抗vegf分子注射。然后在转换后用brolucizumab治疗至少24个月。在2021年1月至2024年6月期间，我们的诊所采用了“根据需要”的治疗方案，在此期间评估了临床和解剖学参数，并记录了可能的不良事件。结果：用brolucizumab治疗24个月后，患者黄斑中央厚度（P = 0.001）和脉络膜厚度显著降低(P)。结论：用brolucizumab治疗之前用其他治疗分子治疗的患者是有效的。在疾病早期切换到brolucizumab治疗的患者获得了最好的结果。在该人群中使用brolucizumab治疗显示出可接受的风险概况，在302例玻璃体内注射中只有一例眼内炎症事件。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. 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