Brolucizumab initiation often occurs after another anti-VEGF
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Most patients in the IRIS Registry and Komodo Database who initiated brolucizumab previously used another form of anti-VEGF treatment, according to research presented at the virtual American Academy of Ophthalmology annual meeting.
Of the 93.7% of patients who began treatment with brolucizumab, 70.8% switched from aflibercept, 14.6% switched from ranibizumab and 14.6% switched from bevacizumab.
Marco A. Zarbin, MD, PhD, FACS, professor at Rutgers New Jersey Medical School, said the results “suggest that unmet needs continue for many patients with wet age-related macular degeneration who receive current anti-VEGF.”
Zarbin and colleagues conducted a retrospective analysis using electronic health record data from the IRIS Registry and medical and pharmacy claims data from the Komodo Health Database. Their analysis included 10,594 eyes of adults (n = 9,547) with wet AMD who received brolucizumab via intravitreal administration and excluded patients with unknown laterality. Researchers identified events using ICD codes, which they acknowledged was a limitation of the study. The follow-up period was up to 6 months, which they also wrote was a limitation.
Incidence of intraocular inflammation was similar in the IRIS Registry (2.39%) compared with the Komodo Health Database (2.4%), including for retinal vasculitis or retinal occlusion (IRIS, .55% vs. Komodo, .56%).
Researchers used a multivariate model to identify potential risk factors for intraocular inflammation at baseline. They found an adjusted risk for any intraocular inflammation or retinal occlusion was 2.3% and wrote that results were “similar” among the subgroup or retinal vasculitis or retinal occlusion. Risk factors included previous inflammation or occlusion (IRIS, OR = 4.69; Komodo, OR = 6), female sex (IRIS, OR = 2.23; Komodo, OR = 2.29) and previous treatment with anti-VEGF (IRIS, OR = 1.24; Komodo, OR = 1.04).
“Patients with intraocular inflammation and/or occlusion in the 12 months prior to the first brolucizumab injection had the highest observed risk rate for an event of intraocular inflammation and/or retinal vascular occlusion among patient eyes in the 6 months post first brolucizumab treatment,” Zarbin said. “Further analysis of the IRIS Registry and Komodo Database are ongoing.”
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Zarbin M, et al. PO395. Presented at: American Academy of Ophthalmology annual meeting, Nov. 13-15 (virtual meeting).
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