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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
  • , Deependra V. Singh
  • , Ritesh Narula
  • , Aishwarya Joshi
  • , Aniruddha Agarwal
  • , Anubhav Goyal
  • , Charu Gupta
  • , Daraius Shroff
  • , Giridhar Anantharaman
  • , Jatinder Singh
  • , Pradeep Kumar
  • Prashant Bawankule, Raja Rami Reddy, Rajiv Jain, Ramesh Venkatesh, Ruchir Tiwari, Shalini Sugumar, Shashank Rai Gupta, Shilpi Narnaware, Shrinivas Joshi, Somendra P. Choudhary
  • Eye-Q Superspecialty Eye Hospitals Gurugram
  • Cleveland Clinic Abu Dhabi
  • Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
  • Maastricht University
  • Giridhar Eye Institute
  • Shroff Eye Care
  • The Eye Foundation
  • Sarakshi Netralaya
  • Narayana Nethralaya
  • Army Hospital Research and Referral
  • Retina Department
  • L.V. Prasad Eye Institute India
  • Neoretina Eyecare Institute
  • Save Sight Centre
  • Tewari Eye Centre
  • M. M. Joshi Eye Hospital
  • Complete Eye Care Centre Manish Chamber

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1786-1794
Number of pages9
JournalIndian Journal of Ophthalmology
Volume72
Issue number12
DOIs
StatePublished - Dec 2024

Keywords

  • Brolucizumab
  • neovascular AMD
  • vascular endothelial growth factor

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