Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration

Abstract Introduction To analyze visual and anatomical outcomes in patients switched to brolucizumab and previously treated with other intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for exudative neovascular age-related macular degeneration (nAMD). These outcomes were was as...

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Main Authors: Federico Beretta, Ilaria Zucchiatti, Riccardo Sacconi, Federico Fantaguzzi, Stefano Lingardo, Francesco Bandello, Giuseppe Querques
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Ophthalmology and Therapy
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Online Access:https://doi.org/10.1007/s40123-025-01141-y
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author Federico Beretta
Ilaria Zucchiatti
Riccardo Sacconi
Federico Fantaguzzi
Stefano Lingardo
Francesco Bandello
Giuseppe Querques
author_facet Federico Beretta
Ilaria Zucchiatti
Riccardo Sacconi
Federico Fantaguzzi
Stefano Lingardo
Francesco Bandello
Giuseppe Querques
author_sort Federico Beretta
collection DOAJ
description Abstract Introduction To analyze visual and anatomical outcomes in patients switched to brolucizumab and previously treated with other intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for exudative neovascular age-related macular degeneration (nAMD). These outcomes were was assessed in the real-world setting of a tertiary center with a follow-up period of 2 years. Methods This retrospective longitudinal study included 29 eyes of 24 patients with exudative nAMD previously treated with at least three injections of another intravitreal anti-VEGF molecule. The eyes were then treated with brolucizumab for at least 24 months following the switch. A pro re nata (“as needed”) therapeutic regimen was followed in our clinic between January 2021 and June 2024, during which time clinical and anatomical parameters were evaluated, and possible adverse events were recorded. Results After 24 months of treatment with brolucizumab, patients showed a significant reduction in central macular thickness (P = 0.001) and choroidal thickness (P < 0.001). Visual acuity remained stable during the follow-up period. "Poor responders" had longer disease duration and had received more injections before the switch than "good responders." Adverse events included one subretinal hemorrhage and one intraocular inflammation across 302 injections. Conclusions Treatment with brolucizumab is effective in patients previously treated with other therapeutic molecules. The best outcomes were achieved in patients who switched therapy to brolucizumab early in their disease. Treatment with brolucizumab in this population demonstrated an acceptable risk profile, with only one intraocular inflammatory event out of 302 intravitreal injections.
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spelling doaj-art-7f74f564aa0545c5b07a403f695702dc2025-08-20T02:31:58ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-04-011461325133510.1007/s40123-025-01141-yTwo-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular DegenerationFederico Beretta0Ilaria Zucchiatti1Riccardo Sacconi2Federico Fantaguzzi3Stefano Lingardo4Francesco Bandello5Giuseppe Querques6School of Medicine, Vita-Salute San Raffaele UniversitySchool of Medicine, Vita-Salute San Raffaele UniversitySchool of Medicine, Vita-Salute San Raffaele UniversitySchool of Medicine, Vita-Salute San Raffaele UniversitySchool of Medicine, Vita-Salute San Raffaele UniversitySchool of Medicine, Vita-Salute San Raffaele UniversitySchool of Medicine, Vita-Salute San Raffaele UniversityAbstract Introduction To analyze visual and anatomical outcomes in patients switched to brolucizumab and previously treated with other intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for exudative neovascular age-related macular degeneration (nAMD). These outcomes were was assessed in the real-world setting of a tertiary center with a follow-up period of 2 years. Methods This retrospective longitudinal study included 29 eyes of 24 patients with exudative nAMD previously treated with at least three injections of another intravitreal anti-VEGF molecule. The eyes were then treated with brolucizumab for at least 24 months following the switch. A pro re nata (“as needed”) therapeutic regimen was followed in our clinic between January 2021 and June 2024, during which time clinical and anatomical parameters were evaluated, and possible adverse events were recorded. Results After 24 months of treatment with brolucizumab, patients showed a significant reduction in central macular thickness (P = 0.001) and choroidal thickness (P < 0.001). Visual acuity remained stable during the follow-up period. "Poor responders" had longer disease duration and had received more injections before the switch than "good responders." Adverse events included one subretinal hemorrhage and one intraocular inflammation across 302 injections. Conclusions Treatment with brolucizumab is effective in patients previously treated with other therapeutic molecules. The best outcomes were achieved in patients who switched therapy to brolucizumab early in their disease. Treatment with brolucizumab in this population demonstrated an acceptable risk profile, with only one intraocular inflammatory event out of 302 intravitreal injections.https://doi.org/10.1007/s40123-025-01141-yAge-related macular degenerationAnti-vascular endothelial growth factorBrolucizumabFluid analysisIntraocular inflammationSwitch therapy
spellingShingle Federico Beretta
Ilaria Zucchiatti
Riccardo Sacconi
Federico Fantaguzzi
Stefano Lingardo
Francesco Bandello
Giuseppe Querques
Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration
Ophthalmology and Therapy
Age-related macular degeneration
Anti-vascular endothelial growth factor
Brolucizumab
Fluid analysis
Intraocular inflammation
Switch therapy
title Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration
title_full Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration
title_fullStr Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration
title_full_unstemmed Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration
title_short Two-Years Real-World Experience of a Tertiary Center with Intravitreal Brolucizumab Switch for Treatment of Exudative Neovascular Age-Related Macular Degeneration
title_sort two years real world experience of a tertiary center with intravitreal brolucizumab switch for treatment of exudative neovascular age related macular degeneration
topic Age-related macular degeneration
Anti-vascular endothelial growth factor
Brolucizumab
Fluid analysis
Intraocular inflammation
Switch therapy
url https://doi.org/10.1007/s40123-025-01141-y
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