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Novartis’ brolucizumab superior to aflibercept in neovascular AMD patients, study suggests

New trials have supported claims that brolucizumab is more effective than aflibercept in treating patients with neovascular age-related macular degeneration (nAMD).

The two-year results from the separate Hawk and Harrier trials comparing the two drugs found brolucizumab (Novartis) was consistently better at drying retinal fluid in nAMD patients than Regeneron’s Eylea (aflibercept).

The findings were presented at the recent 2018 American Academy of Ophthalmology annual meeting in Chicago, and reinforce similar findings when the drugs were compared after one year.

After two years researchers discovered 24% of the Hawk trial patients receiving brolucizumab via intravitreal had intra-retinal fluid and/or sub-retinal fluid, compared with 37% of patients receiving aflibercept. In the Harrier trial, those numbers were 24% and 39%, respectively.

“These findings at year two reaffirm the excellent year one brolucizumab data regarding retinal fluid reduction, a key goal for physicians treating patients with nAMD,” the principal investigator of both trials and clinical professor at the University of Southern California’s Roski Eye Institute, Dr Pravin Dugel, said.

Dugel added that patients randomised to brolucizumab 6mg also demonstrated reductions in central subfield thickness (CST) after two years.

The Hawk trial included 1,775 participants with untreated active choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD). They received either 6mg or 3mg of brolucizumab, or 2mg of aflibercept. The Harrier trial involved 1,049 patients randomised to either brolucizumab 6mg or aflibercept 2mg injections.

Additionally, broculizumab injected every three months was shown to be non-inferior to aflibercept every eight weeks for patients with nAMD.

“Over two years, brolucizumab consistently dried retinal fluid better than aflibercept. Additionally, the robust visual gains shown in year one with brolucizumab were maintained in year two,” Novartis’ chief medical officer Dr Shreeram Aradhye said.

“With sustained improvements in key anatomical outcomes that denote disease activity, brolucizumab is an important scientific advance and underscores our commitment to reimagining medicine.”

Approximately 20–25 million people are affected by nAMD globally.

Carl Zeiss

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