BEOVU – New ARMD Treatment

BEOVU (brolucizumab) has been approved by the FDA for the treatment of wet macular degeneration. BEOVU is manufactured by Novartis and is an anti-vascular endothelial growth factor, commonly known as an anti-VEGF. Anti-VEGF injections block the growth of new blood vessels. BEOVU is injected every month for three months and then every 8-12 weeks.

Macular Degeneration

There are two types—wet and dry.  Both affect the central vision causing blurriness, blind spots and/or distortion.

Dry macular degeneration progresses more slowly (over months to years) than wet macular degeneration.  Vision loss is minimal to moderate. There is no treatment for dry macular degeneration.

Wet macular degeneration, however, is more aggressive and can cause significan loss of vision within days to weeks due to abnormal blood vessel growth. Sometimes abnormal blood vessels, called neovascularization, grow from the choroid (one of the layers of the retina) and into the macula.

Abnormal blood vessels leak and bleed.  The fluid and blood can collect within the layers of the retina.  Distortion is common.

Anti-VEGF injections target the abnormal blood vessel growth and limit the damage to the retina and adjacent tissues.

If anti-VEGF therapy is started early in the process of abnormal blood vessel growth, the vision loss from wet macular degeneration can be salvaged.    Further treatments are then used to reduce the chances of a recurrence.

Anti-VEGF Treatments

Anti-VEGF injections have become integral to the treatment of retinal eye diseases where both leakage and bleeding can occur.  Anti-VEGF injections are often used to treat diabetic retinopathy, retinal vascular occlusions, and wet ARMD.

All anti-VEGF medications decrease abnormal blood vessel growth and leakage, and all can be repeated as often as monthly.

BEOVU Dosing

The FDA approved BEOVU based on evidence from two clinical trials of 1459 patients, 50-97 years old, with wet AMD. The trials were conducted at 336 of sites.

The benefit was assessed by measuring the change in visual acuity in patients treated with BEOVU versus patients treated with aflibercept (EYLEA). Visual acuity was measured using a standard letter chart. BEOVU was found to be “non-inferior” to EYLEA.

After one year of treatment, patients treated with BEOVU showed similar visual improvement as patients treated with EYLEA.

The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) every month (approximately every 25 to 31 days) for the first three doses, followed by one dose of 6 mg. every 8 to 12 weeks.

Clinical Use

It will take time for retinal specialists to assess their own results and identify which of their patients will benefit most from BEOVU for the treatment of wet macular degeneration.