Short-term real-world outcomes following intravitreal brolucizumab for neovascular AMD: SHIFT study

Background Brolucizumab has recently been approved in Europe as a novel treatment for patients with neovascular age-related macular degeneration (nAMD). We report on early experiences with real-world outcomes of switch to brolucizumab therapy in previously anti-vascular endothelial growth factor (anti-VEGF)-treated patients. Methods Patients with recalcitrant nAMD were switched to brolucizumab therapy. Functional and structural parameters 4 weeks after first brolucizumab injection were evaluated including best-corrected visual acuity (BCVA (logMAR)), foveal centre point (FCP (mu m)), central subfield retinal thickness (CSRT (mu m)) and macular volume (mm(3)). Results Sixty-three eyes of 57 patients with nAMD (52.6% females) with a mean (+/- SD) age of 79.5 +/- 6.7 years were included. Mean change of BCVA was 0.03 +/- 0.14 logMAR (p=0.115). Significant reductions were recorded for FCP with a mean (+/- SD) change of -66.81 +/- 72.63 mu m, -66.76 +/- 60.71 mu m for CSRT and -0.27 +/- 0.24 mm(3) for macular volume (all p<0.001). Intraocular inflammation was observed in seven eyes of seven patients, including one case of retinal vasculitis. Conclusions The results of the SHIFT study indicate that switch to brolucizumab may represent a treatment option in patients with nAMD poorly responsive to other anti-VEGF agents. Further long-term analyses appear prudent to assess efficacy and safety of brolucizumab in a routine clinical setting.