Andrew Chang1,2,3, Pravin Dugal4, Rishi P. Singh5, Andreas Weichselberger6
Purpose: To compare the brolucizumab and aﬂiber- cept anatomical outcomes from the ﬁrst 16 weeks of HAWK and HARRIER. This time point provides a direct head to head comparison following the load- ing phase.
Methods: Patients were randomized 1:1:1 to brolu- cizumab 3/6 mg or aﬂibercept 2 mg (HAWK) or 1:1 to brolucizumab 6 mg or aﬂibercept 2 mg (HARRIER). After the loading phase, brolucizumab patients received q12w dosing with an option to adjust to q8w based on masked and predetermined disease activity assessments visits. SD-OCT assess- ments were conducted and images analyzed by independent central reading centres.
Results: Mean change in CST from baseline to w16 for brolucizumab 6 mg was -161.4 μM and for aﬂi- bercept was -133.6 μM (P = 0.0016) in the HAWK study. In HARRIER, the mean CST reduction from baseline to Week 16 for brolucizumab 6 mg was
-174.4 μM and for aﬂibercept was -134.2 μM (P < 0.0001). At Week 16, fewer patients on brolucizu- mab 6 mg had retinal ﬂuid (IRF and/or SRF) rela- tive to aﬂibercept and the corresponding ﬂuid reduction rates for brolucizumab 6 mg were 35% (HAWK) and 33% (HARRIER) lower as compared to aﬂibercept (P < 0.0001). Fewer brolucizumab 6 mg patients had sub-RPE ﬂuid compared to aﬂi- bercept patients at Week 16, i.e. 30% (P = 0.0021) and 33% (P = 0.0041) less ﬂuid with brolucizumab in HAWK and HARRIER, respectively, relative to aﬂibercept. Conclusion: Brolucizumab demonstrated statisti- cally better anatomical outcomes compared to aﬂi- bercept with respect to retinal thickness, IRF and/or SRF ﬂuid status and sub-RPE ﬂuid status at w16.