Brolucizumab Linked to Decreases in nAMD Disease Activity Versus Aflibercept


Rishi Singh, MD, discusses differences in disease activity noted among nAMD patients enrolled in the pivotal HAWK and HARRIER trials.

A new analysis of disease activity from the HAWK and HARRIER trials indicates use of brolucizumab (Beovu) was associated greater disease control than use of aflibercept (Eyelea) for neovascular macular degeneration (nAMD).

Based on functional and anatomic data from the phase 3 clinical trials, a team of investigators was able to deduce brolucizumab was associated with a lower risk of disease activity occurrence than aflibercept, which is considered standard of care for nAMD.

Presented on ARVOLearn due to the cancellation of the 2020 Association for Research in Vision (ARVO) annual meeting, the analysis compared disease activity through disease activity assessments using the 2 anti-VEGF agents over 96 weeks. Disease activity assessments occurred at weeks 16, 20, 32, 44, 56, 68, 80, and 92 of both trials with additional assessments occurring at weeks 28, 40, 52, 64, 76, and 88 in the HARRIER trial.

Of note, after 3 monthly loading doses, brolucizumab patients were put on a 12-week dosing regimen unless disease activity was present when they were placed on a permanent 8-week dosing regimen. Aflibercept was dosed on an 8-week interval.

For the purpose of their analysis, investigators used the first disease activity assessments at week 16 to compare treatment arms. At the 16-week analysis, investigators found rates of disease activity and need for 8-week dosing was significantly lower among brolucizumab groups in both HAWK (brolucizumab 3mg=28.1%; brolucizumab 6mg=24.0% vs aflibercept=34.5%; P <.03 for both) and HARRIER (brolucizumab 6mg=22.7% vs aflibercept=32.2%; P=.002) versus aflibercept.

Additionally, investigators found disease activity presence was greater across all disease activity assessments through week 16-96. Qualitative analysis revealed disease activity assessments showed 71.4% and 67.7% of the cases anatomical signs of disease activity were present either alone (35.8%/41.9%) or in combination with function (35.6%/25.8%).

For more on what the analysis tells us about how brolucizumab stacks up against aflibercept in a clinical setting, HCPLive® reached out to lead investigator Rishi Singh, MD, staff physician with Cole Eye Institute at Cleveland Clinic, to take part in the most recent ARVO 2020 House Call.

This study, “Disease Activity Assessments with Brolucizumab vs Aflibercept in Patients with nAMD in HAWK and HARRIER,” was scheduled to be present at ARVO 2020.

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