Hänsli, Christof; Schild, Christin; Pfister, Isabel; Garweg, Justus G (2023). Brolucizumab in Pretreated Neovascular Age-Related Macular Degeneration: Case Series, Systematic Review, and Meta-Analysis. Life, 13(3) MDPI 10.3390/life13030814
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BACKGROUND
Recalcitrant neovascular age-related macular degeneration (rnAMD) despite intensive intravitreal anti-neovascular endothelial growth factor (VEGF) treatment, can be handled by switching to another anti-VEGF agent. This first systematic review and meta-analysis presents long-term data after switching from another anti-VEGF agent to brolucizumab.
METHODS
Retrospective case series over two years of patients switched to brolucizumab, and a systematic review and meta-analysis of peer-reviewed studies presenting patients switched to brolucizumab. Weighted mean differences based on the random-effects models were calculated for best-corrected visual acuity (BCVA) and central subfield thickness (CST).
RESULTS
The systematic review draws on 1200 eyes switched to brolucizumab. The meta-analysis showed a clinically irrelevant decrease in BCVA after one and two months, together with significant decreases in CST for up to one year after the switch but lacking power over 2 years. Of twelve eyes (twelve patients) in our case series, five continued treatment for two years without experiencing significant changes.
CONCLUSIONS
After switch to brolucizumab, a significant morphological improvement with CST reduction was shown in eyes with rnAMD. The small worsening of BCVA may be owing to the chronically active nature of rnAMD. Brolucizumab thus remains a treatment option in rnAMD despite its potential side effects.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology |
UniBE Contributor: |
Garweg, Justus |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2075-1729 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
30 Mar 2023 07:35 |
Last Modified: |
25 Mar 2024 09:23 |
Publisher DOI: |
10.3390/life13030814 |
PubMed ID: |
36983970 |
Uncontrolled Keywords: |
anti-VEGF best-corrected visual acuity brolucizumab central subfield thickness long-term follow-up meta-analysis neovascular age-related macular degeneration recalcitrant nAMD switch |
BORIS DOI: |
10.48350/181072 |
URI: |
https://boris.unibe.ch/id/eprint/181072 |
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