[Real-life experiences with Brolucizumab in recalcitrant neovascular age-related macular degeneration].

4区医学 Q3 Medicine

Ophthalmologe Pub Date : 2022-03-01 Epub Date: 2021-08-05 DOI:10.1007/s00347-021-01474-6

Marius Book, M Ziegler, K Rothaus, H Faatz, M Gutfleisch, G Spital, A Lommatzsch, D Pauleikhoff

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引用次数: 7

Abstract

Background: Pivotal clinical trials have proven brolucizumab to be a potent intravitreal anti-vascular endothelial growth factor (VEGF) drug in patients with neovascular age-related macular degeneration (nAMD). Therefore, it seems to be a promising drug also in patients with recalcitrant nAMD. This article presents the results of patients who were switched to brolucizumab due to persistent fluid under previous anti-VEGF treatment.

Methods: In this study 21 eyes were retrospectively analyzed in which treatment was switched to brolucizumab due to persistent intraretinal (IRF), subretinal (SRF) and/or sub-retinal pigment epithelium (sub-RPE fluid) fluid despite long-term anti-VEGF treatment. Functional and spectral domain optical coherence tomography (SD-OCT) data were investigated at diagnosis of nAMD (I), at switch to brolucizumab (II), 4 weeks after upload of brolucizumab (III) and at first reactivation of macular neovascularization (MNV, IV).

Results: There were no significant changes in fluid distribution between (I) and (II). After upload of brolucizumab (III) a significant reduction of central subfield retinal thickness (CSRT, p = 0.0001), SRF (p = 0.004) and sub-RPE fluid (p = 0.04), but no visual acuity improvement (p = 0.56) were observed.

Conclusion: Intravitreal brolucizumab treatment can achieve significant reductions particularly of SRF and sub-RPE in patients refractory to previous anti-VEGF treatment. Future studies should further investigate the effects of brolucizumab in patients with recalcitrant nAMD.

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[Brolucizumab治疗顽固性血管性年龄相关性黄斑变性的现实经验]。

背景:关键临床试验已经证明brolucizumab是一种有效的用于新生血管性年龄相关性黄斑变性(nAMD)患者的玻璃体内抗血管内皮生长因子(VEGF)药物。因此，对于顽固性nAMD患者，它似乎也是一种很有希望的药物。这篇文章介绍了在先前的抗vegf治疗中由于持续积液而改用brolucizumab的患者的结果。方法:在这项研究中，回顾性分析了21只眼睛，尽管长期抗vegf治疗，但由于视网膜内(IRF)、视网膜下(SRF)和/或视网膜下色素上皮(亚rpe液)积液持续存在，转而使用brolucizumab治疗。在诊断nAMD (I)、切换到brolucizumab (II)、上传brolucizumab (III)后4周和黄斑新生血管首次重新激活(MNV, IV)时，研究功能和光谱域光学相干断层扫描(SD-OCT)数据。(I)和(II)之间的液体分布没有显著变化。上传brolucizumab (III)后，中心亚区视网膜厚度(CSRT, p = 0.0001)、SRF (p = 0.004)和亚区rpe液体(p = 0.04)显著降低，但视力没有改善(p = 0.56)。结论:玻璃体内brolucizumab治疗可以显著降低既往抗vegf治疗难治性患者的SRF和亚rpe。未来的研究应进一步研究brolucizumab对顽固性nAMD患者的影响。

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

Ophthalmologe 医学-眼科学

CiteScore

1.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Der Ophthalmologe is an internationally recognized journal dealing with all aspects of ophthalmology. The journal serves both the scientific exchange and the continuing education of ophthalmologists. Freely submitted original papers allow the presentation of important clinical studies and serve scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Comprehensive reviews on a specific topical issue focus on providing evidenced based information on diagnostics and therapy. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.