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Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie

The anti-vascular endothelial growth factor (anti-VEGF) agent brolucizumab has been approved in the USA in October 2019 and in Europe in February 2020 for the treatment of neovascular age-related macular degeneration (nAMD). The approval was based on the randomized, double-blind phase III studies HA...

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Autores principales: Holz, F. G., Heinz, C., Wolf, A., Hoerauf, H., Pleyer, U.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935813/
https://www.ncbi.nlm.nih.gov/pubmed/33555415
http://dx.doi.org/10.1007/s00347-021-01321-8
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author Holz, F. G.
Heinz, C.
Wolf, A.
Hoerauf, H.
Pleyer, U.
author_facet Holz, F. G.
Heinz, C.
Wolf, A.
Hoerauf, H.
Pleyer, U.
author_sort Holz, F. G.
collection PubMed
description The anti-vascular endothelial growth factor (anti-VEGF) agent brolucizumab has been approved in the USA in October 2019 and in Europe in February 2020 for the treatment of neovascular age-related macular degeneration (nAMD). The approval was based on the randomized, double-blind phase III studies HAWK and HARRIER with a total of 1817 patients. Brolucizumab 6 mg (administered every 12 or 8 weeks depending on the activity of the disease) showed a non-inferior efficacy in terms of best-corrected visual acuity compared to aflibercept 2 mg (administered every 8 weeks). Initial reports on the use of brolucizumab after its approval in the USA indicated a safety signal of rare adverse events termed as retinal vasculitis and/or retinal vascular occlusion that may result in severe loss of vision. Typically, these events occurred in the presence of intraocular inflammation (IOI). A safety review committee (SRC) subsequently carried out an independent analysis of data from the pivotal studies. This article sets out the current state of knowledge and aims to provide users with orientation—from the authors’ perspective—in treating brolucizumab-associated IOI. It appears mandatory to provide patients with information about possible symptoms of IOI. Even though the case reports and the SRC review of HAWK/HARRIER may not yet provide sufficient evidence for any final conclusions, it seems crucial to educate patients about signs and symptoms to ensure an early detection and diagnosis in cases of IOI. Once a patient is diagnosed with IOI, retinal vasculitis, and/or retinal vascular occlusive events, physicians should act promptly with an adequate and intensive anti-inflammatory treatment and brolucizumab treatment should be discontinued. It is important to note that these recommendations are primarily based on the authors’ expert opinions and should be considered as guidance in managing these events rather than a formal protocol or guidelines.
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spelling pubmed-79358132021-03-19 Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie Holz, F. G. Heinz, C. Wolf, A. Hoerauf, H. Pleyer, U. Ophthalmologe Übersichten The anti-vascular endothelial growth factor (anti-VEGF) agent brolucizumab has been approved in the USA in October 2019 and in Europe in February 2020 for the treatment of neovascular age-related macular degeneration (nAMD). The approval was based on the randomized, double-blind phase III studies HAWK and HARRIER with a total of 1817 patients. Brolucizumab 6 mg (administered every 12 or 8 weeks depending on the activity of the disease) showed a non-inferior efficacy in terms of best-corrected visual acuity compared to aflibercept 2 mg (administered every 8 weeks). Initial reports on the use of brolucizumab after its approval in the USA indicated a safety signal of rare adverse events termed as retinal vasculitis and/or retinal vascular occlusion that may result in severe loss of vision. Typically, these events occurred in the presence of intraocular inflammation (IOI). A safety review committee (SRC) subsequently carried out an independent analysis of data from the pivotal studies. This article sets out the current state of knowledge and aims to provide users with orientation—from the authors’ perspective—in treating brolucizumab-associated IOI. It appears mandatory to provide patients with information about possible symptoms of IOI. Even though the case reports and the SRC review of HAWK/HARRIER may not yet provide sufficient evidence for any final conclusions, it seems crucial to educate patients about signs and symptoms to ensure an early detection and diagnosis in cases of IOI. Once a patient is diagnosed with IOI, retinal vasculitis, and/or retinal vascular occlusive events, physicians should act promptly with an adequate and intensive anti-inflammatory treatment and brolucizumab treatment should be discontinued. It is important to note that these recommendations are primarily based on the authors’ expert opinions and should be considered as guidance in managing these events rather than a formal protocol or guidelines. Springer Medizin 2021-02-08 2021 /pmc/articles/PMC7935813/ /pubmed/33555415 http://dx.doi.org/10.1007/s00347-021-01321-8 Text en © The Author(s) 2021 Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden. Die in diesem Artikel enthaltenen Bilder und sonstiges Drittmaterial unterliegen ebenfalls der genannten Creative Commons Lizenz, sofern sich aus der Abbildungslegende nichts anderes ergibt. Sofern das betreffende Material nicht unter der genannten Creative Commons Lizenz steht und die betreffende Handlung nicht nach gesetzlichen Vorschriften erlaubt ist, ist für die oben aufgeführten Weiterverwendungen des Materials die Einwilligung des jeweiligen Rechteinhabers einzuholen. Weitere Details zur Lizenz entnehmen Sie bitte der Lizenzinformation auf http://creativecommons.org/licenses/by/4.0/deed.de.
spellingShingle Übersichten
Holz, F. G.
Heinz, C.
Wolf, A.
Hoerauf, H.
Pleyer, U.
Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie
title Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie
title_full Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie
title_fullStr Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie
title_full_unstemmed Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie
title_short Intraokulare Entzündungen bei Brolucizumab-Anwendung: Patientenmanagement – Diagnose – Therapie
title_sort intraokulare entzündungen bei brolucizumab-anwendung: patientenmanagement – diagnose – therapie
topic Übersichten
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935813/
https://www.ncbi.nlm.nih.gov/pubmed/33555415
http://dx.doi.org/10.1007/s00347-021-01321-8
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