Glenn J. Jaffe
SAN FRANCISCO — Treatment with Beovu resulted in visual acuity letter gains among patients with age-related macular degeneration and polypoidal choroidal vasculopathy, according to a presentation at Retina Subspecialty Day at the American Academy of Ophthalmology annual meeting.
“Most of you have heard that in the last week, Beovu (brolucizumab, Novartis) was approved by the FDA to treat neovascular AMD,” Glenn J. Jaffe, MD, Robert Machemer Professor of Ophthalmology and Chief of the Vitreoretinal Division at Duke Eye Center, said during his presentation. “We know from clinical trials that it is effective for typical AMD.”
However, there are no previous data on how effective brolucizumab was for patients with the polypoidal choroidal vasculopathy form of AMD, according to Jaffe.
Jaffe and colleagues conducted a substudy of the Japanese participants in the HAWK trial, in which nearly 60% had polypoidal choroidal vasculopathy.
The substudy comprised 152 Japanese participants, of the total 1,078 that were enrolled. All patients, including those in the substudy, received 3 mg or 6 mg doses of brolucizumab or 2 mg of aflibercept (Eylea, Regeneron) for a matched treatment phase through week 16, according to Jaffe. Afterward, patients in the aflibercept group received dosing every 8 weeks and those in the brolucizumab group received dosing every 12 weeks. If the brolucizumab-treated eyes had active disease at pre-defined intervals, the dosing frequency was reduced to every 8 weeks.
Results showed that improvements in visual acuity were similar among the different treatment arms, averaging around 10.5 to 11.5 letter gains.
More than three-quarters of patients receiving 6 mg of brolucizumab were able to stay on the every 12-week dosing regimen by week 48, as were approximately 70% of patients in the same group by week 96.
All groups had decreased central subfield thickness. However, more patients in the aflibercept group had residual subretinal/ intraretinal fluid and sub-RPE fluid than those in the brolucizumab groups. Rates of severe adverse events were similar among the different treatment arms.
“In this planned subanalysis, there were robust visual acuity gains in the patients who had polypoidal choroidal vasculopathy across all of the treatment arms,” Jaffe said.
“Brolucizumab monotherapy works well not only in typical AMD but also these patients with polypoidal choroidal vasculopathy,” he added. – by Alaina Tedesco
Reference: Jaffe GJ. Comparison of the efficacy and safety of brolucizumab vs. aflibercept in eyes with polypoidal choroidal vasculopathy: 96-week results from the HAWK study. Presented at: American Academy of Ophthalmology annual meeting; Oct. 11-15, 2019; San Francisco.
Disclosure: Jaffe reports being a consultant for Clearside, EyePoint, EyeVensys, Heidelberg Engineering, Neurotech and Novartis Pharma AG.