A new treatment for wet age-related macular degeneration could see patients receiving just four injections a year. Previously, sufferers needed monthly injections to slow the condition's progress. Brolucizumab (trade name Beovu) was approved for use in Scotland in September 2020 and has now been approved for use in England and Wales by the National Institute for Health and Care Excellence (NICE) on the NHS.

The drug, which was designed to attach to and block a substance called VEGF-A, could see patients going as much as 12 weeks between eye injections. More than 50% of patients in clinical trials were able to maintain vision with 3-month intervals between doses.

VEGF-A is a protein that makes blood vessels grow and leak fluid and blood, damaging the macula. By blocking VEGF-A, brolucizumab reduces the growth of the blood vessels and controls the leakage and swelling.

NICE’s recommendation was based on findings from clinical trials (HAWK and HARRIER) which showed that almost a third of patients could see at least 15 more letters in standard eye tests as early as four weeks into the trial.

The American Academy of Opthalmology (AAO) states that the 96-week results from the phase 3 HAWK and HARRIER trials show that brolucizumab provides vision gains comparable with those of aflibercept (an existing drug used to treat AMD), but yields greater fluid resolution and a high probability of remaining on a q12w regimen (treatment once every 12 weeks) from weeks 48 to 96. According to Robin Hamilton, Consultant Ophthalmic Surgeon at Moorfields Eye Hospital and UK Chief Investigator for the HARRIER study, “[This] offers patients access to a treatment option that has the potential to minimise the treatment burden and hospital visits while improving their vision and slowing down the progression of their wet AMD. This should give them more time to do the things that matter most to them.”

Managing Director UK, Ireland & Nordics for Novartis Pharmaceuticals, Chinmay Bhatt, adds, “This is more vital than ever to help relieve pressure on healthcare systems. We are working closely with the NHS to ensure eligible patients can start benefiting from brolucizumab as soon as possible.”

Sources:

1. Pharmatimes.
2. BNF Nice.
3. Pub Med.
4. Macular Society.
5. AAO Journal.