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Real-world Evaluation of Brolucizumab for the Treatment of Neovascular (Wet) Age-related Macular Degeneration (AMD) (IRIS Study)

Completed
Conditions
Age-related Macular Degeneration (AMD)
Interventions
Registration Number
NCT05082415
Lead Sponsor
Novartis Pharmaceuticals
Brief Summary

This study was a retrospective cohort study of patients to assess the early insights into real-world safety among wet AMD patients initiating brolucizumab. Evidence was generated to describe their patient characteristics and clinical outcomes. The study was conducted using the IRIS Registry.

Detailed Description

IRIS Registry EHR data from patients with wet AMD who initiated brolucizumab were analyzed in this study.

Identification period of the index date (index period): The patients fulfilling the selection criteria was identified

* Index date: Defined as the date of the earliest brolucizumab injection

* Study Period: The period from the first patient eye exposure to brolucizumab to the last follow-up recorded

* Pre-index period: The period 36 months prior to the index date. Data within 36 months prior to the index date will be used to assess baseline characteristics.

* Post-index period: The period 180 days after the index date

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
9456
Inclusion Criteria
  1. ≥1 Healthcare Common Procedure Coding System (HCPCS) code (J code) or EMR note for treatment with brolucizumab during the index period (date of earliest code or EMR note = index date)

  2. ≥18 years old on the index date

  3. ≥1 Current Procedural Terminology (CPT) code for intravitreal administration on the index date

  4. ≥1 International Classification of Diseases, Clinical Modification-9/10 (ICD-9/10) code for wet AMD in the 36 months prior to or on the index date

    o Note: Off-label use of brolucizumab is not expected given payer access restrictions in the US.

  5. ≥1 follow-up visit after the index date

  6. ≥1 VA assessment on the index date or within 90 days prior to the index date

Exclusion Criteria
  1. Use of brolucizumab prior to 10/8/2019 (e.g. clinical trials)
  2. Unknown laterality of the index eye on the index date

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
BrolucizumabBrolucizumabParticipants received brolucizumab injection during the index period
Primary Outcome Measures
NameTimeMethod
Number of patient eyes with an Intraocular Inflammation (IOI) event during the first 6 monthsUp to 6 months post brolucizumab injection

To assess IOI events observed after starting treatment with brolucizumab

Secondary Outcome Measures
NameTimeMethod
AgeAt the brolucizumab index date defined as the date of first brolucizumab injection

Age information was reported

Gender informationAt the brolucizumab index date defined as the date of first brolucizumab injection

Gender information was reported

Number of patients at various Patient RegionAt the brolucizumab index date defined as the date of first brolucizumab injection

Patient regions: Northeast, Midwest, South, West, Unknown

Number of patients with Insurance typeAt the brolucizumab index date defined as the date of first brolucizumab injection

Insurance type: Medicare, Medicare Advantage, Medicaid, Commercial, Government, Military, No Insurance, Miscellaneous, Unknown

Number of patients with Laterality of wet Age-related macular degeneration (AMD)At the brolucizumab index date defined as the date of first brolucizumab injection

Laterality of wet AMD: Unilateral, Bilateral

Race/Ethnicity of the participants (patient level and eye level)At the brolucizumab index date defined as the date of first brolucizumab injection

Caucasian, Black or African American, Asian, Other, Unknown

Number of eyes with the concurrent eye diseaseWithin 180 days prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Types of concurrent eye diseases: ▪ Cataracts

* Posterior vitreous detachment

* Puckering of macula

* Macular hole

* Vitreomacular traction

* Glaucoma

* Amblyopia

* Papillitis

* Ischemic optic atrophy

* Diabetic retinopathy

* Diabetic macular edema

* Hypertensive retinopathy

* Pathologic myopia

* RAO

* RO

* RV

* Vitritis

* Endophthalmitis

* Uveitis

* Choroidal neovascularization (due to causes other than AMD, if possible, to determine)

* IOI

Number of patient eyes with cataract status36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Types: phakic, pseudophakic, aphakic

Number of patient eyes with Concomitant ocular medications36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Types:

* Corticosteroids

* Prednisone

* Prednisolone acetate

* Difluprednate

* Biologics

* Cyclosporine

* Methotrexate

* Ganciclovir

* Acyclovir

* Trifluridine

* Rituxan

Number of patient eyes with the history of ocular inflammation36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

The following categories were reported:

* No history of inflammation

* History of any ocular inflammation

* History of severe ocular inflammation

* History of anterior inflammation

* History of posterior inflammation

* History of IOI or endophthalmitis due to infections and other underlying disease (separate category)

Number of patient eyes with prior Intraocular Inflammation (IOI) and/or prior Retinal vascular occlusion (RO)12 months prior to the index date ( index date defined as the date of first brolucizumab injection)

Included history of ocular inflammation or occlusion

Number of patient eyes with the Provider specialtyAt the brolucizumab index date defined as the date of first brolucizumab injection

The following types were included:

Retina specialist, General ophthalmologist, Non-retina specialist, unknown

Number of patient eyes with the previous ocular surgeries or procedures6 months prior to the index date ( index date defined as the date of first brolucizumab injection)

The following categories were included:

* Laser therapy

* Laser coagulation

* Photodynamic therapy

* IOP lowering surgeries (lasers, glaucoma filtering, non-filtering glaucoma)

* Cataract surgery

* Iridotomy

* Intraocular or refractive surgery (almost all IOP \& cataract surgeries)

* Previous penetrating keratoplasty, vitrectomy, or ocular radiation

* Previous panretinal photocoagulation

* Previous submacular surgery, other surgical intervention or laser treatment for AMD

Number of ocular adverse events (AEs)Post-index period defined as the 180 days following therapy initiation, excluding index date

To assess the incidence of ocular AEs among patients treated with brolucizumab

Time since wet Age-related macular degeneration (AMD) diagnosis36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Patients were measured at the eye level

Time since any Age-related macular degeneration (AMD) diagnosis36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Patients were measured at the eye level

Time from last anti-VEGF injection to index date (among switchers)At the brolucizumab index date defined as the date of first brolucizumab injection

The following categories were measured:

* Continuous (days)

* Categorical (0-30, 31-60, 61-90, 91+ days)

Number of eyes treated with brolucizumabAt the brolucizumab index date defined as the date of first brolucizumab injection

The following types were included:

OD \[eye, right\], OS \[eye, left\], Unspecified, Unilateral, Bilateral)

Number of patient eyes with Visual Acuity (VA) readingAt the brolucizumab index date defined as the date of first brolucizumab injection with lookback of 365 days

The following categories were included:

* Snellen: 20/10, 20/12-20/20, 20/25-20/40, 20/50-20/160, ≤20/200

* Approximate ETDRS letters

Number of patient eyes with Anti-VEGF treatment-naive vs prior-treated36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Anti-VEGF treatment-naive vs prior-treated were measured at the eye level

Number of patient eyes with the prior treatment status36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

The following types were included:

off-label bevacizumab, ranibizumab, aflibercept, unknown, treatment-naive

Number of different prior anti-VEGF agents36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

The following categories were measured at the eye level:

0, 1, 2, ≥3

Number of prior anti-VEGF injections36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Total, per anti-VEGF agent were measured at the eye level)

* Continuous

* Categorical: \<6, 6 to \<12, 12 to \<24, ≥24

Duration of last anti-VEGF treatment36-month period prior to the index date (inclusive of the index date) ( index date defined as the date of first brolucizumab injection)

Total, per anti-VEGF agent; will be measured at the eye level

* All anti-VEGFs i. Continuous ii. Categorical: \<6, 6 to \<12, 12 to \<24, ≥24 months

* Specific anti-VEGF iii. Continuous iv. Categorical: \<6, 6 to \<12, 12 to \<24, ≥24 months

Trial Locations

Locations (1)

Novartis Pharmaceuticals

🇺🇸

East Hanover, New Jersey, United States

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