大剂量布卢珠单抗治疗对标准剂量布卢珠单抗耐药的难治性新生血管性老年性黄斑变性。

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-30 DOI:10.1007/s40123-024-01022-w

Jinsoo Kim, Min Seon Park, Bum-Joo Cho, Soonil Kwon

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引用次数: 0

摘要

简介本研究旨在评估在难治性新生血管性年龄相关性黄斑变性（AMD）患者中增加玻璃体内brolucizumab剂量的有效性和安全性：这项回顾性研究纳入了17名难治性AMD患者的17只眼睛，他们接受了12个多月的高剂量brolucizumab（12毫克/0.1毫升）治疗。患者最初至少接受了一种抗血管内皮生长因子（anti-VEGF）药物治疗，之后转用标准剂量的brolucizumab（6毫克/0.05毫升）。那些对标准剂量治疗反应不佳的患者，其布卢单抗的剂量则会增加：高剂量治疗 12 个月后，视力从 68.3 ± 3.4 个字母维持到 70.7 ± 3.2 个字母（P = 0.128）。大剂量治疗前，中心视野下厚度为 343.7 ± 17.0 μm，12 个月后为 316.7 ± 18.5 μm（P = 0.083）。大剂量治疗后，视网膜下积液和浆液性色素上皮脱落患者的比例分别从 82.4% 和 52.9% 显著降至 41.2% 和 17.6%（P = 0.039 和 P = 0.031）。改用标准剂量博卢单抗后，治疗间隔从（7.2±2.4）周延长至（10.2±2.2）周（P 结论：标准剂量博卢单抗的治疗间隔从（7.2±2.4）周延长至（10.2±2.2）周：对于从以前的抗血管内皮生长因子药物转为标准剂量的博路单抗无效的患者来说，大剂量博路单抗是有效的。增加剂量可为难治性AMD患者提供持续的疾病控制并减轻治疗负担。

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High-Dose Brolucizumab for Refractory Neovascular Age-Related Macular Degeneration Resistant to Standard-Dose Brolucizumab.

Introduction: The aim of this study was to evaluate the efficacy and safety of escalating the dosage of intravitreal brolucizumab in patients with refractory neovascular age-related macular degeneration (AMD).

Methods: This retrospective study included 17 eyes of 17 patients with refractory AMD treated with high-dose brolucizumab (12 mg/0.1 ml) for over 12 months. Patients initially received at least one anti-vascular endothelial growth factor (anti-VEGF) agent and were switched to standard-dose brolucizumab (6 mg/0.05 ml). Those who showed a suboptimal response to standard-dose treatment had their dosage of brolucizumab escalated.

Results: Visual acuity was maintained from 68.3 ± 3.4 letters to 70.7 ± 3.2 letters after 12 months of high-dose treatment (P = 0.128). Central subfield thickness was 343.7 ± 17.0 μm before high-dose treatment and 316.7 ± 18.5 μm at 12 months (P = 0.083). The proportions of patients with subretinal fluid and serous pigment epithelial detachment significantly decreased from 82.4% to 41.2% and from 52.9% to 17.6%, respectively, after high-dose treatment (P = 0.039 and P = 0.031, respectively). The treatment interval extended from 7.2 ± 2.4 weeks to 10.2 ± 2.2 weeks after switching to standard-dose brolucizumab (P < 0.001) and was maintained at 13.5 ± 2.8 weeks after increasing the dose (P = 0.154). No severe ocular adverse events were observed.

Conclusions: High-dose brolucizumab was effective in patients who did not respond to standard-dose brolucizumab after switching from previous anti-VEGF agents. Increasing the dosage could offer sustained disease control and reduce the treatment burden for patients with refractory AMD.

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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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