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

Abstract

ObjectiveTo compare the efficacy of brolucizumab and aflibercept treatment in reducing maximum thickness of pigment epithelial detachments (PED) and sub-retinal pigment epithelium (sub-RPE) fluid in patients with neovascular age-related macular degeneration (nAMD) in the HAWK and HARRIER studies. DesignHAWK and HARRIER were 96-week, prospective, randomized, double-masked, controlled, multicenter studies Subjects, participants, and/or controls1,775 patients across 11 countries were included in the HAWK study and 1,048 patients across 29 countries were included in the HARRIER study. Method and interventionsAfter three monthly loading doses, brolucizumab-treated eyes received injections every 12 weeks (q12w) or q8w if disease activity (DA) was detected. Aflibercept-treated eyes received fixed q8w dosing. Main outcomes measuresMaximum thickness of PED 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). ResultsAt Week 96, there were greater mean percentage reductions from baseline in maximum thickness of both PED and sub-RPE fluid in brolucizumab-treated patients versus 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. ConclusionsThis analysis shows that brolucizumab achieved greater reductions in PED and sub-RPE fluid thickness than aflibercept in HAWK and HARRIER.