Randall Wong, M.D.

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A new drug, Beovu (brolucizumab), is now FDA approved for the treatment of wet macular degeneration.  Beovu, manufactured by Novartis, is an anti-VEGF injection. Like other anti-VEGF injections, Beovu may be used in patients requiring multiple treatments, but at a more extended dosing schedule.

Macular Degeneration

There are two types of macular degeneration:  wet and dry.  

Dry macular degeneration usually progresses quite slowly (over months to years) and leads to minimal to moderate vision.  There is no treatment for dry macular degeneration.

Wet macular degeneration can be more aggressive causing loss of vision over days to weeks.  Abnormal blood vessels (neovascular blood vessels) can develop within the layers of the retina.  These vessels lead and bleed, hence the term “wet.”  

Anti-VEGF medications selectively target the neovascular tissue thereby limiting damage to the adjacent normal retinal tissue.

If caught in time, vision loss from wet macular degeneration can be improved.  Treatments are then aimed at reducing the chances of recurrence.

Anti-VEGF Treatments

All anti-VEGF treatments decrease leakage and can cause regression of the neovascular tissue.  All can be repeated as often as monthly.

Other anti-VEGF injections include:  Avastin, Lucentis, Eylea and Macugen.

Anti-VEGF injections have become the mainstay of treating diabetic retinopathy, retinal vascular occlusions and wet ARMD.  All are similar in that both leakage and bleeding can occur.

BEOVU - Extended Dosing

Beovu was compared to Eylea and was found to be “non-inferior” with respect to vision improvement.  Beovu, however, is approved for a 3 month dosing schedule and may represent a unique advantage for retina specialists’ use compared to other anti-VEGFs on the market.

In short, Beovu may work as well as other anti-VEGFs, but may be injected every 12 weeks instead of every 4-6 months.

Though FDA approved, it is likely that use of Beovu will be slow as retina specialists identify exactly which patients will benefit the most from this new treatment for wet macular degeneration. 

 

December 16, 2019
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