Indian Journal of Ophthalmology (Dec 2024)

Initial experience with brolucizumab for neovascular age-related macular degeneration (nAMD) in India – Multicentric, real-world study

  • Deependra Vikram Singh,
  • Aniruddha Agarwal,
  • Anubhav Goyal,
  • Daraius Shroff,
  • Jatinder Singh,
  • Pradeep Kumar,
  • Raja Rami Reddy,
  • Ramesh Venkatesh,
  • Shilpi Narnaware,
  • Shrinivas Joshi,
  • Delhi Retina Forum Study Group,
  • Singh Deependra V,
  • Narula Ritesh,
  • Joshi Aishwarya,
  • Agarwal Aniruddha,
  • Goyal Anubhav,
  • Gupta Charu,
  • Shroff Daraius,
  • Anantharaman Giridhar,
  • Singh Jatinder,
  • Kumar Pradeep,
  • Bawankule Prashant,
  • Reddy Raja Rami,
  • Jain Rajiv,
  • Venkatesh Ramesh,
  • Tiwari Ruchir,
  • Sugumar Shalini,
  • Gupta Shashank Rai,
  • Narnaware Shilpi,
  • Joshi Shrinivas,
  • Choudhary Somendra P

DOI
https://doi.org/10.4103/IJO.IJO_757_24
Journal volume & issue
Vol. 72, no. 12
pp. 1786 – 1794

Abstract

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Purpose: To evaluate the anatomic and visual outcomes and safety profile of initial Indian eyes with neovascular age-related macular degeneration (nAMD) treated with intravitreal injection (IVI) of brolucizumab. Methods: This retrospective multicentric, real-world study enrolled consecutive eyes with nAMD that were treated with IVI brolucizumab after it was launched in India in October 2020. Data collected for each eye included best-corrected visual acuity (BCVA), central subfield thickness (CSFT), subretinal fluid (SRF), and intraretinal fluid (IRF) status at 6, 12, and 24 months follow-up. Also recorded were the lens status, treatment protocol, number of injections received before enrollment (in switch-over cases), total number of injections, and adverse effects noticed during the study period. Primary outcomes were change in BCVA, CSFT at follow-up visits, and incidence of intraocular inflammation (IOI). Secondary outcomes were profile of macular neovascularization, treatment protocols, mean number of injections, and maximum injection-free interval observed in eyes treated by pro-re-nata (PRN) protocol. Results: In total, 331 eyes received a mean of 3.55 ± 1.83 injections. Most frequent treatment protocol was PRN (53%). BCVA data was available for 100%, 96%, and 74% eyes at 6, 12, and 24 months follow-up. BCVA and CSFT improved significantly (P < 0.001) at all follow-ups. Two hundred and seventy-six (83.38%) out of 331 eyes received more than one injection; out of these, 241 (87.3%) eyes that were treated by PRN protocol could achieve mean “maximum injection-free interval” of 19.43 ± 8.82 weeks. IOI and retinal vasculitis were reported in 2.11% (7/331) and 0.60% (2/331) eyes, respectively. None of the eyes with IOI or vasculitis lost any vision at the final follow-up. Conclusion: This study demonstrated favorable visual and anatomic outcomes and safety profile for eyes with nAMD treated by IVI brolucizumab. Mean maximum injection-free interval in eyes treated with PRN was 19 weeks.

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