4CPS-152 Effectiveness and safety of brolucizumab in age-related macular degeneration

<h3>Background and Importance</h3> Age-related macular degeneration (AMD) leads to the release of vascular endothelial growth factor (VEGF). The treatment consists of anti-VEGF drugs administered via intravitreal. Brolucizumab is an anti-VEGF used as a third-line treatment. <h3>Aim and Objectives</h3> To assess brolucizumab’s effectiveness and safety as a second- or third-line AMD treatment. <h3>Material and Methods</h3> Retrospective observational study of exudative AMD patients who started brolucizumab treatment between November 2022 and March 2024. <h3>Collected variables</h3> age, sex, lesions, intraretinal/subretinal fluid (IRF/SRF), dosage, previous treatments, changes or discontinuation and reasons, visual acuity according to clinical criteria, and brolucizumab-related adverse events (AEs). Effectiveness was assessed by visual acuity at week 48 (primary outcome) and IRF/SRF reduction (secondary). Safety was evaluated by recording ocular and non-ocular AEs. <h3>Results</h3> 112 patients (50% male, median age 79) had started brolucizumab. Both eyes were affected in 4.5% of cases. Neovascular lesions appeared in 68.7%, IRF/SRF in 91%, cataracts in 40.2%, pigment epithelial detachment (PED) in 47.8%, intraretinal cysts in 35.7%, and cystoid macular oedema in 8%. The dosing regimen followed the drug label in 37.5% and Treat and Extend/Pro-Re-Nata (PRN) in 62.5%. Brolucizumab was first-line in 1.78% (clinical trial), second-line after aflibercept in 34.8%, and third-line after aflibercept and ranibizumab in 63.4%. 13.4% had been treated for at least 48 weeks. Of these, 80% are still in treatment: 53.3% improved in visual acuity and 73.3% showed IRF/SRF reduction. The causes for the suspension of the treatment were: 46.4% switched to faricimab due to persistent IRF/SRF or no visual improvement, 7.3% due to disease stability, and 46.3% lost to follow-up. Ocular AEs included PED (n=4), eyelid inflammation (n=2), and submacular haemorrhage (n=5). In any patient non-ocular AEs were reported. <h3>Conclusion and Relevance</h3> Compared to the HAWK/HARRIER trials, an improvement in visual acuity is observed in 53.3% versus 56%/51% in the trials, and a reduction in FIR/FSR of 73.3% versus 31%/26%. However, further studies are needed in a larger patient cohort receiving treatment for up to 48 weeks in order to compare it properly. Safety was similar to that of the trials. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest