Uncontrolled Wet AMD: Drug Switch Can Mute Disease Activity

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Uncontrolled Wet AMD: Drug Switch Can Mute Disease Activity
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Some patients with uncontrolled neovascular age-related macular degeneration achieved a reduction in disease activity and gains in visual acuity after switching to the biologic agent brolucizumab, according to a new study presented ARVO2023. nAMD

April 25, 2023

"The study shows there's a benefit; I can recommend this treatment," said Tadayoni, who also is a professor at the University of Paris. The drug works against vascular endothelial growth factor attached to a human single-chain antibody fragment, allowing for greater dosing of anti-VEGF per volume. Since its release, brolucizumab has come under scrutinySWIFT is an ongoing 48-week, single-arm, open-label study conducted across 52 sites in France. All patients in the trial had active choroidal neovascularization lesions diagnosed within the previous 18 months while undergoing treatment every 4 or 8 weeks.

The proportion of patients with no disease activity at week 16 was 40.4%, with consistent benefit across subgroups. A mean increase from baseline in BCVA of 4.1 letters was also observed as was a mean decrease in CSFT of −51 µm, according to the researchers. While 85% of patients had SRF fluid at baseline, this figure dropped to 53% at week 16; the incidence of dry retina improved from 1.4% at baseline to 31.3% after treatment, Tadayoni's group reported.

The committee confirmed intraocular inflammation-only in 20 patients, inflammation plus retinal vasculitis in six , and inflammation plus retinal vascular occlusion in two . One patient had inflammation plus both retinal vasculitis and retinal vascular occlusion. For these events, the incident rate per 1000 injections was, respectively, 12.50, 3.75, 1.25, and 0.63, Tadayoni reported.

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