Factors Linked to Injection Interval Extension in Eyes with Wet Age-Related Macular Degeneration Switched to Brolucizumab

Ophthalmology Volume 130, Number 8, August 2023

中文摘要

這篇文章是探討患有wet age related macular degeneration（nAMD）且轉換至brolucizumab治療的患者，與抗血管內皮生長因子（VEGF）注射間隔延長相關的因素。該研究旨在找出可能影響brolucizumab治療注射間隔延長的因素，這對於因需要頻繁注射而治療負擔較重的患者可能有益。

研究參與者是在2019年10月8日至2021年11月26日期間，從其他抗VEGF藥物轉換至僅使用brolucizumab治療的nAMD成年患者，並進行至少12個月的追蹤。主要結果措施是在12個月時將眼睛分類為“延長者”或“非延長者”，其中延長者是指在brolucizumab注射間隔上實現至少2週延長並在12個月時保持穩定或改善視力的眼睛。

研究發現轉換至brolucizumab前較短的注射間隔與brolucizumab治療注射間隔延長呈正相關。視力指數在40到65字母的眼睛相較於視力更好的眼睛，更不太可能成為延長者。研究還提到，雖然brolucizumab治療可能對於因需要頻繁注射而治療負擔較重的患者提供了有價值的選擇，但由於與brolucizumab相關的眼內炎(intraocular inflammation)的風險，需要仔細考慮其利弊。

這項研究有一些限制，例如對於轉換至brolucizumab的原因缺乏記錄和對注射間隔延長的嚴格定義。然而，它為nAMD患者接受brolucizumab治療的治療結果影響因素提供了有價值的見解。

English Abstract

Abstract:
This scientific research paper investigates factors related to extended injection intervals in patients with neovascular age-related macular degeneration (nAMD) who switched to brolucizumab treatment. The study aims to identify potential factors influencing the extension of injection intervals with brolucizumab therapy, which may be beneficial for patients burdened by frequent injections.

Methods:
Participants were adult patients with nAMD who switched from other anti-vascular endothelial growth factor (VEGF) drugs to brolucizumab treatment between October 8, 2019, and November 26, 2021, and were followed up for at least 12 months. The primary outcome measure was classifying eyes as “extenders” or “non-extenders” at 12 months, with extenders achieving at least a 2-week extension in brolucizumab injection interval and maintaining stable or improved vision at 12 months.

Results:

Of 2015 eyes among 1890 patients who switched to brolucizumab treatment, 1186 (58.9%) were
extenders. The study found a positive correlation between shorter injection intervals before switching to brolucizumab and extended injection intervals with brolucizumab treatment. Eyes with visual acuity scores in the range of 40 to 65 letters were less likely to be extenders compared to eyes with better visual acuity. The research also noted that while brolucizumab treatment may offer a valuable option for patients burdened by frequent injections, the risks associated with brolucizumab-related intraocular inflammation need careful consideration.

Limitations:
This study has some limitations, such as the lack of recorded reasons for switching to brolucizumab and a strict definition for extended injection intervals. However, it provides valuable insights into factors influencing treatment outcomes for nAMD patients receiving brolucizumab therapy.