Effect of Brolucizumab and Aflibercept on the Maximum Thickness of Pigment Epithelial Detachments and Sub-Retinal Pigment Epithelium Fluid in HAWK and HARRIER

Arshad M Khanani; Srinivas R Sadda; David Sarraf; Ramin Tadayoni; David T Wong; Anne-Sophie Kempf; Insaf Saffar; Kinfemichael Gedif; Andrew Chang

doi:10.1016/j.oret.2024.07.012

Effect of Brolucizumab and Aflibercept on the Maximum Thickness of Pigment Epithelial Detachments and Sub-Retinal Pigment Epithelium Fluid in HAWK and HARRIER

Ophthalmol Retina. 2024 Jul 19:S2468-6530(24)00335-X. doi: 10.1016/j.oret.2024.07.012. Online ahead of print.

Authors

Arshad M Khanani¹, Srinivas R Sadda², David Sarraf³, Ramin Tadayoni⁴, David T Wong⁵, Anne-Sophie Kempf⁶, Insaf Saffar⁶, Kinfemichael Gedif⁶, Andrew Chang⁷

Affiliations

¹ Sierra Eye Associates, Reno, Nevada; Reno School of Medicine, University of Nevada, Reno, Nevada. Electronic address: [email protected].
² Doheny Eye Institute, University of California, Los Angeles, Los Angeles, California.
³ Stein Eye Institute, University of California, Los Angeles, Los Angeles, California; Ophthalmology, Greater Los Angeles VA Healthcare Center, Los Angeles, California.
⁴ Department of Ophthalmology, Université Paris Cité, AP-HP, Lariboisière, Saint Louis and Fondation Adolphe de Rothschild Hospitals, Paris, France.
⁵ Department of Ophthalmology and Vision Sciences, Unity Health Toronto - St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
⁶ Novartis Pharma AG, Basel, Switzerland.
⁷ Sydney Retina Clinic, Sydney Eye Hospital, Sydney University, Sydney, New South Wales, Australia.

PMID: 39033924
DOI: 10.1016/j.oret.2024.07.012

Abstract

Objective: To compare the efficacy of brolucizumab and aflibercept treatment in reducing the maximum thickness of pigment epithelial detachments (PEDs) and sub-retinal pigment epithelium (sub-RPE) fluid in patients with neovascular age-related macular degeneration in the HAWK and HARRIER studies.

Design: HAWK and HARRIER were 96-week, prospective, randomized, double-masked, controlled, multicenter studies.

Participants: A total of 1775 patients across 11 countries were included in the HAWK study, and 1048 patients across 29 countries were included in the HARRIER study.

Intervention: After 3 monthly loading doses, brolucizumab-treated eyes received injections every 12 weeks or every 8 weeks if disease activity (DA) was detected. Aflibercept-treated eyes received fixed 8-week dosing.

Main outcome measures: Maximum thickness of PEDs and sub-RPE fluid across the macula were assessed at baseline through week 96 in the brolucizumab- and aflibercept-treated patients and in the patient subgroups with DA at week 16 (matched in terms of injection number and treatment interval).

Results: At week 96, there were greater mean percentage reductions from baseline in maximum thickness of both PEDs and sub-RPE fluid in brolucizumab-treated patients vs. aflibercept-treated patients (PED: 19.7% [n = 336] vs. 11.9% [n = 335] in HAWK; 29.5% [n = 364] vs. 18.3% [n = 361] in HARRIER. Sub-RPE fluid: 75.4% vs. 57.3% in HAWK; 86.0% vs. 76.3% in HARRIER). A similar trend in mean percentage reductions was observed in patients with DA at week 16.

Conclusions: This analysis shows that brolucizumab achieved greater reductions in PEDs and sub-RPE fluid thickness than aflibercept in HAWK and HARRIER.

Trial registration: ClinicalTrials.gov Identifiers: NCT02307682 (HAWK) and NCT02434328 (HARRIER).

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Keywords: Aflibercept; Brolucizumab; Neovascular age-related macular degeneration; Pigment epithelial detachments; Sub-retinal pigment epithelium.

Associated data

ClinicalTrials.gov/NCT02434328
ClinicalTrials.gov/NCT02307682