4CPS-048 Brolucizumab: effectiveness and safety in routine clinical practice

<h3>Background and Importance</h3> Management of neovascular age-related macular degeneration (AMD) and diabetic macular oedema (DMO) includes lifelong anti-VEGF injections. Brolucizumab, a newer longer-acting anti-VEGF agent, has demonstrated efficacy and allowed extended treatment intervals in clinical trials. However, intraocular inflammation-related adverse events (AEs) have been associated to brolucizumab. Therefore, there is limited data from real-world clinical practice. <h3>Aim and Objectives</h3> To evaluate the effectiveness and safety of intravitreal brolucizumab in patients with AMD or DMO in clinical practice. <h3>Material and Methods</h3> This observational, retrospective study included patients diagnosed with AMD or DMO treated with brolucizumab from October 2022 to March 2024. Data were collected from prescription system and medical records, including demographics, ocular pathology, previous AMD or DMO intravitreal treatments, reasons for switching to brolucizumab, dosage, duration, AEs and reasons for discontinuation. Effectiveness was evaluated in terms of visual acuity (VA). Patients who had received prior treatment with other anti-VEGF did not receive a loading dose of brolucizumab. <h3>Results</h3> A total of 60 patients (68 eyes) were included, with a mean age of 78.3 years. 82% had AMD and 18% had DMO. Prior to brolucizumab, 59% of eyes had been treated with one anti-VEGF, 37% with two or more, and only one (1.5%) patient was treatment-naïve. Reasons for switching included lack of response (67.6%), loss of efficacy (1.5%), and AEs (2.9%). Baseline VA was 0.35. After brolucizumab VA improved significantly from 0.30 to 0.38 (p=0.005). The mean treatment interval was 8.5 weeks, with 25% of patients receiving a single dose. In 6.7% of patients, a dosing interval of 12 weeks or more was achieved within 1 year. AEs, including uveitis (n=1), photophobia (n=1), increased intraocular pressure (n=1) and choroidopathy (n=1), led to discontinuation in four patients. Other reasons for discontinuation included lack of efficacy (n=3) and loss of response (n=3). <h3>Conclusion and Relevance</h3> This study suggests that brolucizumab may be an effective alternative for patients unresponsive to other anti-VEGF treatments, potentially allowing longer dosing intervals. However, due to the study’s limitations, further research with larger sample sizes is required to confirm its safety profile. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest