Twelve-Month Outcomes of Brolucizumab in Routine Clinical Practice: Fight Retinal Blindness! Registry

We analysed 12-month real-world outcomes of treatment of eyes with neovascular age-related macular degeneration switched to brolucizumab from a first-generation VEGF inhibitor to determine whether switching chronically active eyes that required frequent treatment improved control of the disease safely with fewer injections.

Retrospective analysis of Australian and Italian data from the prospectively designed observational Fight Retinal Blindness! registry. We studied eyes that switched to brolucizumab and received at least two injections with 12 months of follow-up.

Of the 81 eligible eyes, the proportion of inactive lesions increased from 5% at baseline to 37% 12 months after switching to brolucizumab (p < 0.001). Mean (95% CI) visual acuity (VA) was stable (0.6 [-1.5, 2.8] letters, p = 0.55), while median treatment intervals increased from 44 to 63 days (p < 0.001). Nearly a third (30%) of eyes switched back to another VEGF inhibitor within 12 months. Eyes that stayed on brolucizumab had a significantly longer mean treatment interval at 12 months than eyes that switched off it (66.1 [Q1, Q3: 56, 91] vs. 49 [28, 63.2] days, p ≤ 0.001) while VA change and inactivation rates were similar. Intraocular inflammation (IOI) was recorded in 7 (9%) eyes receiving at least one injection of brolucizumab.

Eyes that switched from a first generation VEGF inhibitor to brolucizumab in routine clinical practice achieved a clinically significant extension of their treatment interval, with more than a third becoming inactive but with a relatively high rate of IOI.