Indian Journal of Ophthalmology (Jan 2024)

Brolucizumab in age-related macular neovascularization (BRAIN study): Efficacy, optical coherence tomography biomarkers, and safety profile

  • Supriya Dabir,
  • Arthi Mohankumar,
  • Manoj G Khatri,
  • Mohan Rajan

DOI
https://doi.org/10.4103/IJO.IJO_927_23
Journal volume & issue
Vol. 72, no. 13
pp. 33 – 36

Abstract

Read online

Background: Brolucizumab is a new anti-vascular endothelial growth factor (anti-VEGF) in the treatment of neovascular age-related macular degeneration (nAMD) and idiopathic polypoidal choroidal vasculopathy (IPCV). Materials and Methods: A retrospective, consecutive, interventional study was conducted from a tertiary eye hospital, in which treatment-naïve and treatment-switch patients were included. They underwent an intravitreal injection of brolucizumab. The decision to reinject was made based on the presence of fluid on spectral domain optical coherence tomography (SD-OCT) or worsening of vision at follow-up. Outcome measures were changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), fluid (subretinal/intraretinal/sub-retinal pigment epithelium fluid) levels, and OCT biomarkers and safety analysis. Results: A total of 59 eyes of 50 patients with a total of 132 intravitreal injections were included. There was a statistically significant improvement (P < 0.05) in BCVA from baseline in logMAR treatment-naïve patients (mean BCVA at baseline 0.6 ± 0.41 and 0.37 ± 0.56). The mean baseline CST of all patients significantly reduced from 582.92 ± 233.11 μm at baseline to 474.06 ± 252.89 μm at the final treatment visit. Thirty-eight percent of patients showed complete resolution of SHRM after a single injection. The interval between each subsequent injection increased from a mean of 67 to 96 days in treatment-switch patients and from 47 to 151 days in treatment-naïve patients. Conclusion: Brolucizumab promises reduced number of injections with longer treatment intervals.

Keywords