Age-related macular degeneration (AMD) is a disease of the macula and a leading cause of vision loss. Neovascular AMD, also known as wet AMD, is a type of AMD that is characterized by choroidal neovascularization, which results in the leakage of fluid, lipids, and blood.
In 2019, the US Food and Drug Administration approved the drug brolucizumab (Beovu) for treating wet AMD. Although it displayed promise in its ability to administer the medication at a high concentration, brolucizumab was recently reexamined because of its link to cases of intraocular inflammation (IOI), retinal vasculitis (RV), and retinal vascular occlusion (RO).
After the publication of these findings, a study was launched to assess the incidence of and risk factors for IOI, including RV, and/or RO after treatment with brolucizumab in patients with wet AMD. The study found that the incidence of IOI and/or RO after treatment was about 2.4%, with a history of IOI and/or RO identified as a risk factor for such complications.
Nevertheless, the study was limited in its noninterventional and retrospective nature, precluding the ability to establish a causal relationship between brolucizumab treatment and IOI and/or RO. In addition, as the median follow-up in the study was only 3 months, the study provides a limited evaluation of the long-term safety outcomes associated with brolucizumab treatment. Another concern is that patients with a history of IOI and/or RO may be more diligently monitored for future complications, which may explain why a history of IOI and/or RO was identified as a risk factor for IOI and/or RO after treatment.
These findings call for further investigation into the safety of brolucizumab for treating wet AMD. Interventional studies with longer follow-up periods should be conducted to determine potential causality between brolucizumab and long-term complications including IOI and/or RO.
For now, clinicians should focus on monitoring patients, especially those with a history of IOI and/or RO, for potential complications after brolucizumab treatment for wet AMD. However, more research will be required to establish its long-term safety outcomes.
Ashley Y. Gao is an undergraduate student at the University of Minnesota Twin Cities and is majoring in human physiology.
Sophie J. Bakri, MD, a long-time contributor to Medscape, specializes in diseases and surgery of the retina and vitreous, including age-related macular degeneration. She also undertakes both clinical and translational research in the pathogenesis and treatment of retinal diseases.
Lead image: Retina Gallery
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Ashley Y. Gao, Sophie J. Bakri. Reevaluating the Safety of Brolucizumab for Treating Wet Age-Related Macular Degeneration - Medscape - Mar 11, 2022.