Intraocular Inflammation, Safety Events, and Outcomes After Intravitreal Injection of Ranibizumab, Aflibercept, Brolucizumab, Abicipar Pegol, and Faricimab for nAMD.

IF 0.5 Q4 OPHTHALMOLOGY
Marta Stevanovic, Nicole Koulisis, Tom Chen, Stavros N Moysidis, Bruce Burkemper, Brian C Toy, Narsing A Rao, Dean Eliott, Mark S Humayun
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Abstract

Purpose: To compare the rates of intraocular inflammation (IOI) in patients with neovascular age-related macular degeneration (nAMD) after injection of intravitreal (IVT) antivascular endothelial growth factor drugs. Methods: This study included all phase 3 randomized clinical trials of patients with nAMD treated with ranibizumab, aflibercept, brolucizumab, abicipar pegol, or faricimab. The outcomes assessed were the incidence of IOI, retinal artery occlusion (RAO), retinal vasculitis and choroiditis, endophthalmitis, and serious systemic adverse events (AEs) as well as the change in visual acuity (VA) (Early Treatment Diabetic Retinopathy Study letters) and in central retinal thickness (CRT). Results: Abicipar pegol was associated with a higher incidence of IOI than aflibercept, ranibizumab, faricimab, and sham injections, while brolucizumab was associated with a higher rate of IOI than aflibercept, faricimab, and sham injections. Abicipar pegol was also associated with a higher rate of endophthalmitis than aflibercept. Significantly more retinal vasculitis and choroiditis was seen with abicipar pegol and brolucizumab than with ranibizumab and aflibercept, respectively, and RAOs occurred more frequently with abicipar pegol and brolucizumab than with ranibizumab and aflibercept, respectively. There were no differences in the change in VA among the drugs. Treatment with brolucizumab resulted in a greater change in CRT than with abicipar pegol, aflibercept, ranibizumab, and faricimab, while treatment with faricimab resulted in a greater change in CRT than aflibercept and ranibizumab. Faricimab was associated with fewer serious systemic AEs than aflibercept. Conclusions: Abicipar pegol and brolucizumab were associated with a higher incidence of ocular AEs in phase 3 randomized controlled trials. The potential benefits of these drugs should be weighed against the AEs.

玻璃体腔内注射雷尼单抗、阿非利塞普、Brolucizumab、Abicipar Pegol和Faricimab治疗nAMD后的眼内炎症、安全事件和结果。
目的:比较新生血管性年龄相关性黄斑变性(nAMD)患者玻璃体内注射抗血管内皮生长因子(IVT)药物后眼内炎症(IOI)的发生率。方法:该研究纳入了所有接受雷尼单抗、阿非利塞普、布卢珠单抗、阿比匹帕佩果或法利昔单抗治疗的nAMD患者的3期随机临床试验。评估的结果是IOI、视网膜动脉闭塞(RAO)、视网膜血管炎和脉络膜炎、眼内炎、严重全身不良事件(ae)的发生率,以及视力(VA)(早期治疗糖尿病视网膜病变研究信)和视网膜中央厚度(CRT)的变化。结果:与阿非利西普、雷尼单抗、法利西单抗和假性注射相比,阿比昔帕佩果与更高的IOI发生率相关,而布卢珠单抗与更高的IOI发生率相关,高于阿非利西普、法利西单抗和假性注射。阿比西帕佩戈里与阿非利普相比,眼内炎的发生率也更高。与雷尼单抗和阿非利塞普相比,阿比匹帕佩戈尔和布卢珠单抗组的视网膜血管炎和脉管炎发生率明显更高,阿比匹帕佩戈尔和布卢珠单抗组的RAOs发生率分别高于雷尼单抗和阿非利塞普组。不同药物之间的VA变化没有差异。与阿比匹帕佩戈、阿非利西普、雷尼单抗和法利西单抗相比,用勃卢珠单抗治疗导致CRT的变化更大,而用法利西单抗治疗导致CRT的变化比阿非利西普和雷尼单抗更大。法利西单抗与阿布西普相比,更少发生严重的系统性不良反应。结论:在3期随机对照试验中,Abicipar pegol和brolucizumab与较高的眼部ae发生率相关。这些药物的潜在益处应该与不良反应进行权衡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.20
自引率
16.70%
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