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 KumarPrashant Bawankule, Raja Rami Reddy, Rajiv Jain, Ramesh Venkatesh, Ruchir Tiwari, Shalini Sugumar, Shashank Rai Gupta, Shilpi Narnaware, Shrinivas Joshi, Somendra P Choudhary, Delhi Retina Forum Study Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-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
Publication statusPublished - 29 Nov 2024

Keywords

  • Humans
  • Intravitreal Injections
  • Male
  • India/epidemiology
  • Retrospective Studies
  • Female
  • Angiogenesis Inhibitors/administration & dosage
  • Visual Acuity
  • Aged
  • Wet Macular Degeneration/drug therapy diagnosis physiopathology
  • Tomography, Optical Coherence/methods
  • Follow-Up Studies
  • Antibodies, Monoclonal, Humanized/administration & dosage therapeutic use
  • Treatment Outcome
  • Fluorescein Angiography/methods
  • Vascular Endothelial Growth Factor A/antagonists & inhibitors
  • Middle Aged
  • Fundus Oculi
  • Aged, 80 and over

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