Researchers conducted a post-hoc analysis of the prospective, phase III HAWK and HARRIER trials to assess the efficacy and safety of brolucizumab versus aflibercept in patients with wet age-related macular degeneration (AMD). Fewer brolucizumab injections were required to achieve sustained dryness over a 96-week period, and sustained dryness was achieved faster and more frequently in brolucizumab-treated patients. The results of the study were published as part of the American Society of Retina Specialists 2020 Virtual Annual Meeting.
Patients were randomized to receive brolucizumab 3 mg (from the HAWK trial only) or 6 mg (via three loading doses, followed by treatment every 12 weeks, with an option to adjust to every eight weeks if disease activity was present) or aflibercept 2 mg (every eight weeks). Sustained dryness was defined as three or more consecutive fluid-free visits (defined as absence of both intraretinal fluid and subretinal fluid) at the 50th and 75th percentiles.
Sustained dryness was achieved faster with brolucizumab than aflibercept in both clinical trials. At week 96, a higher proportion of patients receiving brolucizumab achieved sustained dryness compared with aflibercept, and sustained dryness was also achieved to a greater degree in brolucizumab-treated patients. Fewer brolucizumab injections were required to achieve the 50th percentile and 75th percentile for sustained dryness from baseline.
“Having a more durable drug allows for a potential of optimal visual outcomes with less treatment burden,” the authors noted. “These outcomes suggest that brolucizumab treatment results in better disease control than aflibercept, thereby potentially reducing the treatment burden in wet AMD in the long term.”
Regillo CD, Wyckoff CC, Yang Y, et al. Number of Injections and Time to Dry Analysis of Brolucizumab Versus Aflibercept in Patients with Neovascular AMD: 96-Week Data From HAWK and HARRIER. Presented during the ASRS 2020 Virtual Annual Meeting, July 24-26, 2020.