RAPTOR: Assessing the Efficacy and Safety of Brolucizumab Versus Aflibercept in Patients With Visual Impairment Due to Macular Edema Secondary to Branch Retinal Vein Occlusion

Sponsor
Novartis Pharmaceuticals (Industry)
Overall Status
Terminated
CT.gov ID
NCT03802630
Collaborator
(none)
450
102
2
24.8
4.4
0.2

Study Details

Study Description

Brief Summary

The purpose of this study was to evaluate the efficacy and safety of brolucizumab in treatment of patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

Condition or Disease Intervention/Treatment Phase
  • Drug: Brolucizumab 6 mg
  • Drug: Aflibercept 2 mg
  • Other: Sham injection
Phase 3

Detailed Description

The study was comprised of a Screening period (Day -28 to Day -1), Double-masked treatment period (Day 1 to Week 72) and Post-treatment follow-up period (Week 72 to Week 76). Treatment visits were scheduled in 4-week intervals. After 6 initial monthly injections of brolucizumab or aflibercept (loading phase), subjects entered a one-year individualized flexible treatment (IFT) phase. During the IFT phase, an assessment of disease stability was performed at each monthly visit and subjects received either an active or a sham injection. Treatment with active was interrupted when disease stability was reached.

Study Design

Study Type:
Interventional
Actual Enrollment :
450 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Investigator, Outcomes Assessor)
Masking Description:
A masked evaluating investigator was responsible for all aspects of the study except the injections and the safety assessment following the injections. An unmasked treating investigator performed the injections and assessed patient safety following the injections.
Primary Purpose:
Treatment
Official Title:
An Eighteen-Month, Two-Arm, Randomized, Double Masked, Multicenter, Phase III Study Assessing the Efficacy and Safety of Brolucizumab Versus Aflibercept in Adult Patients With Visual Impairment Due to Macular Edema Secondary to Branch Retinal Vein Occlusion
Actual Study Start Date :
Jul 2, 2019
Actual Primary Completion Date :
Jul 26, 2021
Actual Study Completion Date :
Jul 26, 2021

Arms and Interventions

Arm Intervention/Treatment
Experimental: Brolucizumab 6 mg

1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)

Drug: Brolucizumab 6 mg
Solution for injection (intravitreal use)
Other Names:
  • RTH258
  • ESBA1008
  • Other: Sham injection
    Empty sterile syringe without a needle administered as a sham injection for masking purposes. From Week 24 to Week 72 inclusive, a sham treatment was performed to maintain subject masking in case treatment with brolucizumab or aflibercept was not deemed necessary by the investigator.

    Active Comparator: Aflibercept 2 mg

    1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)

    Drug: Aflibercept 2 mg
    Solution for injection (Intravitreal use)
    Other Names:
  • EYLEA®
  • Other: Sham injection
    Empty sterile syringe without a needle administered as a sham injection for masking purposes. From Week 24 to Week 72 inclusive, a sham treatment was performed to maintain subject masking in case treatment with brolucizumab or aflibercept was not deemed necessary by the investigator.

    Outcome Measures

    Primary Outcome Measures

    1. Change From Baseline in Best-corrected Visual Acuity (BCVA) at Week 24 [Baseline, Week 24]

      BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning. Missing and censored BCVA values were imputed by Last observation carried forward (LOCF) as the primary approach. Observed values from both scheduled and unscheduled post-baseline visits were used for the LOCF imputation. For subjects with no post-baseline BCVA value, the baseline value was carried forward.

    Secondary Outcome Measures

    1. Change From Baseline in BCVA Averaged Over Week 40 to Week 52 [Baseline, Week 40 to Week 52]

      An average BCVA over week 40 to week 52 was calculated. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning.

    2. Change From Baseline in BCVA Averaged Over Week 64 to Week 76 [Baseline, Week 64 to Week 76]

      An average BCVA over week 64 to week 76 was calculated. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning.

    3. Change From Baseline in BCVA by Visit up to Week 76 [Baseline and every 4 weeks from baseline up to Week 76]

      BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning.

    4. Proportion of Participants With a Gain ≥ 5, 10 and 15 Letters in BCVA by Visit Compared to Baseline [Baseline and every 4 weeks from baseline up to Week 76]

      The summary by visit was conducted based on the BCVA observed from each of the corresponding visits. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning. Every 5 letters represents 1 line of vision on the reading chart.

    5. Proportion of Participants With a Loss ≥ 5, 10 and 15 Letters in BCVA by Visit Compared to Baseline [Baseline and every 4 weeks from baseline up to Week 76]

      The summary by visit was conducted based on the BCVA observed from each of the corresponding visit. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning. Every 5 letters represents 1 line of vision on the reading chart.

    6. Change From Baseline in CSFT Averaged Over Week 40 to Week 52 [Baseline, Week 40 to Week 52]

      Change from baseline in central subfield thickness (CSFT) averaged over Week 40 to Week 52 , measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)

    7. Change From Baseline in CSFT Averaged Over Week 64 to Week 76 [Baseline, Week 64 to Week 76]

      Change from baseline in central subfield thickness (CSFT) averaged over Week 64 to Week 76, measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)

    8. Change From Baseline in CSFT by Visit up to Week 76 [Baseline, and every 4 weeks from baseline up to Week 76]

      Change from baseline in central subfield thickness (CSFT) measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)

    9. Proportion of Subjects With Presence of Retinal Fluid (Intra- and/or Subretinal Fluid) in the Study Eye by Visit up to Week 76 [Every 4 weeks from baseline up to Week 76]

      Presence of retinal fluid (intra- and/or subretinal fluid) assessed by Spectral Domain Optical Coherence Tomography (SD-OCT)

    10. Proportion of Subjects With a CSFT < 300 µm for the Study Eye by Visit up to Week 76 [Every 4 weeks from Week 4 up to Week 76]

      Central subfield thickness (CSFT) is measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)

    11. Number of Injections Between Week 24 and Week 52 and Between Week 24 and Week 72 [Week 24 to Week 52 and Week 24 to Week 72]

      Number of administered injections during the individualized flexible treatment (IFT) period, between Week 24 and Week 52 and between Week 24 and Week 72 are presented

    12. Time to Recurrence After Week 20 and up to Week 76 [Week 20 to Week 76]

      Recurrence is defined as the need for injection while showing a lack of disease stability for the first time after Week 20 and up to Week 76. For subjects with recurrence after the Week 20 visit, time-to-event is calculated as (first time with the lack of disease stability - the injection date on Week 20 visit + 1). For subjects without recurrence after Week 20, the censoring time will be calculated as (last visit with disease stability assessment - the injection date on Week 20 visit + 1).

    13. Number of Subjects With Ocular and Non-ocular AEs up to Week 52 and Week 76 [Baseline to Week 76]

      Number of subjects with at least one ocular or non-ocular Adverse Events (AEs).

    14. Change From Baseline in Patient Reported Outcomes (NEI VFQ-25) at Week 24, Week 52 and Week 76 [Baseline, Week 24, Week 52 and Week 76]

      The National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) measures a patient's subjective assessment of vision-related Quality of Life (QoL). The 11 subscales in the VFQ-25 are general vision, ocular pain, near activities, distance activities, social functioning, mental health, role difficulties, dependency, driving, color vision, and peripheral vision. The scores on the subscales were added together for a total score, which ranged from 0 to 100. A higher score indicated better vision-related quality of life.

    15. Number of Subjects According to Their Anti-drug Antibody (ADA) Titer at Screening and Week 4, Week 12, Week 24, Week 36, Week 52 and Week 76 [Baseline, Week 4, Week 12, Week 24, Week 36, Week 52 and Week 76]

      Anti-drug antibodies (ADA) levels were assessed from subjects assigned to brolucizumab treatment only.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Signed informed consent must be obtained prior to participation in the study.

    • Patients with visual impairment due to ME secondary to BRVO diagnosed < 6 months prior to screening.

    • BCVA score between 78 and 23 letters, inclusive, using ETDRS visual acuity testing charts (approximate Snellen equivalent of 20/32 to 20/320) at both screening and baseline visits.

    Exclusion criteria

    • Concomitant conditions or ocular disorders in the study eye at screening or baseline which could, in the opinion of the investigator, prevent response to study treatment or may confound interpretation of study results, compromise visual acuity or require medical or surgical intervention during the first 12-month study period (e.g. structural damage of the fovea, vitreous hemorrhage, retinal vascular occlusion other than BRVO, retinal detachment, macular hole, or choroidal neovascularization of any cause, diabetic retinopathy (except mild non-proliferative) and diabetic macular edema). Hemiretinal vein occlusion should be excluded.

    • Any active intraocular or periocular infection or active intraocular inflammation (e.g. infectious conjunctivitis, keratitis, scleritis, endophthalmitis, infectious blepharitis, uveitis) in study eye at screening or baseline

    • Uncontrolled glaucoma in the study eye defined as intraocular pressure (IOP) > 25 mmHg on medication, or according to investigator's judgment, at screening or baseline

    • Presence of amblyopia, amaurosis or ocular disorders in the fellow eye with BCVA < 20/200 at screening (except when due to conditions whose surgery may improve VA, e.g. cataract)

    • Previous treatment with any anti-VEGF therapy or investigational drugs in the study eye at any time prior to baseline

    • Previous use of intraocular or periocular steroids in study eye at any time prior to baseline

    • Macular laser photocoagulation (focal/grid) in the study eye at any time prior to baseline and peripheral laser photocoagulation in the study eye within 3 months prior to the baseline

    • Intraocular surgery in the study eye during the 3-month period prior to baseline

    • Vitreoretinal surgery in the study eye at any time prior to baseline

    • Aphakia with the absence of posterior capsule in the study eye

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Novartis Investigative Site Phoenix Arizona United States 85020
    2 Novartis Investigative Site Mountain View California United States 94040
    3 Novartis Investigative Site Santa Barbara California United States 93103
    4 Novartis Investigative Site Colorado Springs Colorado United States 80909
    5 Novartis Investigative Site Pensacola Florida United States 32503
    6 Novartis Investigative Site Saint Petersburg Florida United States 33711
    7 Novartis Investigative Site Indianapolis Indiana United States 46280
    8 Novartis Investigative Site New Albany Indiana United States 47150
    9 Novartis Investigative Site Leawood Kansas United States 66211
    10 Novartis Investigative Site Lenexa Kansas United States 66215
    11 Novartis Investigative Site Stoneham Massachusetts United States 02180
    12 Novartis Investigative Site Reno Nevada United States 89502
    13 Novartis Investigative Site Bloomfield New Jersey United States 07003
    14 Novartis Investigative Site Asheville North Carolina United States 28803
    15 Novartis Investigative Site Charlotte North Carolina United States 28210
    16 Novartis Investigative Site Cleveland Ohio United States 44122
    17 Novartis Investigative Site Monroeville Pennsylvania United States 15146
    18 Novartis Investigative Site Abilene Texas United States 79606
    19 Novartis Investigative Site Arlington Texas United States 76012
    20 Novartis Investigative Site Austin Texas United States 78731
    21 Novartis Investigative Site Austin Texas United States 78750
    22 Novartis Investigative Site Bellaire Texas United States 77401
    23 Novartis Investigative Site Houston Texas United States 77025
    24 Novartis Investigative Site Houston Texas United States 77030
    25 Novartis Investigative Site San Antonio Texas United States 78240
    26 Novartis Investigative Site Madison Wisconsin United States 53705-3611
    27 Novartis Investigative Site Graz Austria A-8036
    28 Novartis Investigative Site Calgary Alberta Canada T2H0C8
    29 Novartis Investigative Site London Ontario Canada N6A 4V2
    30 Novartis Investigative Site Ottawa Ontario Canada K1Z 8R2
    31 Novartis Investigative Site Toronto Ontario Canada M5T 2S8
    32 Novartis Investigative Site Quebec Canada G1S 4L8
    33 Novartis Investigative Site Guangzhou Guangdong China 510060
    34 Novartis Investigative Site Wuhan Hubei China 430070
    35 Novartis Investigative Site Wuxi Jiangsu China 214002
    36 Novartis Investigative Site Chengdu Sichuan China 610041
    37 Novartis Investigative Site Tianjin Tianjin China 300020
    38 Novartis Investigative Site Tianjin Tianjin China 300070
    39 Novartis Investigative Site Wenzhou Zhejiang China 325027
    40 Novartis Investigative Site Beijing China 100044
    41 Novartis Investigative Site Beijing China 100730
    42 Novartis Investigative Site Chongqing China 400038
    43 Novartis Investigative Site Shanghai China 200080
    44 Novartis Investigative Site Pardubice Czechia 532 03
    45 Novartis Investigative Site Praha 10 Czechia 100 34
    46 Novartis Investigative Site Praha Czechia 12808
    47 Novartis Investigative Site Copenhagen Denmark 2100
    48 Novartis Investigative Site Strasbourg Bas Rhin France 67000
    49 Novartis Investigative Site Saint Cyr sur Loire Indre Et Loire France 37540
    50 Novartis Investigative Site Bordeaux France 33000
    51 Novartis Investigative Site Creteil France 94000
    52 Novartis Investigative Site Dijon France 21034
    53 Novartis Investigative Site Marseille France F 13008
    54 Novartis Investigative Site Paris cedex 10 France 75010
    55 Novartis Investigative Site Paris France 75015
    56 Novartis Investigative Site Regensburg Bavaria Germany 93053
    57 Novartis Investigative Site Bonn Germany 53105
    58 Novartis Investigative Site Duesseldorf Germany 40212
    59 Novartis Investigative Site Freiburg Germany 79106
    60 Novartis Investigative Site Gottingen Germany 37075
    61 Novartis Investigative Site Leipzig Germany 04103
    62 Novartis Investigative Site Ludwigshafen Germany 67063
    63 Novartis Investigative Site Mainz Germany 55131
    64 Novartis Investigative Site Muenster Germany 48145
    65 Novartis Investigative Site Ulm Germany 89075
    66 Novartis Investigative Site Hongkong Hong Kong
    67 Novartis Investigative Site Jerusalem Israel 91031
    68 Novartis Investigative Site Petach Tikva Israel 4941492
    69 Novartis Investigative Site Zerifin Israel 6093000
    70 Novartis Investigative Site Catania CT Italy 95123
    71 Novartis Investigative Site Pisa PI Italy 56124
    72 Novartis Investigative Site Roma RM Italy 00133
    73 Novartis Investigative Site Roma RM Italy 00198
    74 Novartis Investigative Site Udine UD Italy 33100
    75 Novartis Investigative Site Nagoya-city Aichi Japan 467-8602
    76 Novartis Investigative Site Amagasaki city Hyogo Japan 660 8550
    77 Novartis Investigative Site Ishioka Ibaraki Japan 315-0037
    78 Novartis Investigative Site Chiyoda-ku Tokyo Japan 101-8309
    79 Novartis Investigative Site Taito-ku Tokyo Japan 111-0051
    80 Novartis Investigative Site Osaka Japan 543-0027
    81 Novartis Investigative Site Arecibo Puerto Rico 00612
    82 Novartis Investigative Site Cheboksary Russian Federation 428028
    83 Novartis Investigative Site Moscow Russian Federation 119021
    84 Novartis Investigative Site Saratov Russian Federation 410012
    85 Novartis Investigative Site Sterlitamak Russian Federation 453128
    86 Novartis Investigative Site Bratislava Slovakia 85107
    87 Novartis Investigative Site Nitra Slovakia 950 01
    88 Novartis Investigative Site Zvolen Slovakia 960 01
    89 Novartis Investigative Site Sevilla Andalucia Spain 41009
    90 Novartis Investigative Site Sant Cugat Catalunya Spain 08190
    91 Novartis Investigative Site Santiago de Compostela Galicia Spain 15706
    92 Novartis Investigative Site Barcelona Spain 08021
    93 Novartis Investigative Site Madrid Spain 28040
    94 Novartis Investigative Site Lausanne Vaud Switzerland 1006
    95 Novartis Investigative Site Binningen Switzerland 4102
    96 Novartis Investigative Site Changhua Taiwan 50006
    97 Novartis Investigative Site Taipei Taiwan 10002
    98 Novartis Investigative Site Westcliff-on-Sea Essex United Kingdom SS0 0RY
    99 Novartis Investigative Site Bradford West Yorkshire United Kingdom BD9 6RJ
    100 Novartis Investigative Site Birmingham United Kingdom B18 7QH
    101 Novartis Investigative Site Liverpool United Kingdom L7 8XP
    102 Novartis Investigative Site London United Kingdom NW3 2QG

    Sponsors and Collaborators

    • Novartis Pharmaceuticals

    Investigators

    • Study Director: Novartis Pharmaceuticals, Novartis Pharmaceuticals

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Novartis Pharmaceuticals
    ClinicalTrials.gov Identifier:
    NCT03802630
    Other Study ID Numbers:
    • CRTH258C2301
    • 2018-001842-33
    First Posted:
    Jan 14, 2019
    Last Update Posted:
    Jul 28, 2022
    Last Verified:
    Jun 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Novartis Pharmaceuticals
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details Participants were recruited from 103 sites in 18 countries
    Pre-assignment Detail The study comprised a screening period of 28 days
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Period Title: Overall Study
    STARTED 226 224
    COMPLETED 73 76
    NOT COMPLETED 153 148

    Baseline Characteristics

    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg Total
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) Total of all reporting groups
    Overall Participants 226 224 450
    Age (Years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [Years]
    65.4
    (11.05)
    65.0
    (10.92)
    65.2
    (10.97)
    Sex: Female, Male (Count of Participants)
    Female
    117
    51.8%
    125
    55.8%
    242
    53.8%
    Male
    109
    48.2%
    99
    44.2%
    208
    46.2%
    Race/Ethnicity, Customized (Number) [Number]
    White
    154
    68.1%
    153
    68.3%
    307
    68.2%
    Black or African American
    8
    3.5%
    4
    1.8%
    12
    2.7%
    Asian
    65
    28.8%
    67
    29.9%
    132
    29.3%

    Outcome Measures

    1. Primary Outcome
    Title Change From Baseline in Best-corrected Visual Acuity (BCVA) at Week 24
    Description BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning. Missing and censored BCVA values were imputed by Last observation carried forward (LOCF) as the primary approach. Observed values from both scheduled and unscheduled post-baseline visits were used for the LOCF imputation. For subjects with no post-baseline BCVA value, the baseline value was carried forward.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Full Analysis Set (FAS) included all randomized subjects who received at least one Intravitreal injection of the study treatment.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Least Squares Mean (Standard Error) [Letters read]
    13.1
    (0.71)
    15.0
    (0.71)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Brolucizumab 6 mg, Aflibercept 2 mg
    Comments
    Type of Statistical Test Non-Inferiority
    Comments Non-inferiority was considered established if the lower limit of the corresponding 95% CI for the estimated between group difference (brolucizumab vs. aflibercept) on change from baseline in BCVA at Week 24 is greater than -4 letters.
    Statistical Test of Hypothesis p-Value 0.018
    Comments
    Method ANOVA
    Comments
    Method of Estimation Estimation Parameter Least Square Mean Difference
    Estimated Value -1.9
    Confidence Interval (2-Sided) 95%
    -3.9 to 0.1
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 1.01
    Estimation Comments
    2. Secondary Outcome
    Title Change From Baseline in BCVA Averaged Over Week 40 to Week 52
    Description An average BCVA over week 40 to week 52 was calculated. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning.
    Time Frame Baseline, Week 40 to Week 52

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had a valid assessment for both baseline and the corresponding post baseline period.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 123 132
    Mean (Standard Deviation) [Letters read]
    12.9
    (12.81)
    16.9
    (10.63)
    3. Secondary Outcome
    Title Change From Baseline in BCVA Averaged Over Week 64 to Week 76
    Description An average BCVA over week 64 to week 76 was calculated. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning.
    Time Frame Baseline, Week 64 to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had a valid assessment for both baseline and the corresponding post baseline period.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 110 121
    Mean (Standard Deviation) [Letters read]
    13.7
    (13.33)
    17.9
    (10.65)
    4. Secondary Outcome
    Title Change From Baseline in BCVA by Visit up to Week 76
    Description BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning.
    Time Frame Baseline and every 4 weeks from baseline up to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had a valid assessment for both baseline and the corresponding post baseline visit.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 4
    9.2
    (8.22)
    10.3
    (10.13)
    Week 8
    11.9
    (10.68)
    12.8
    (10.84)
    Week 12
    13.2
    (10.22)
    14.8
    (11.23)
    Week 16
    12.2
    (12.59)
    16.3
    (11.58)
    Week 20
    13.5
    (10.83)
    16.3
    (12.15)
    Week 24
    12.7
    (12.36)
    16.6
    (11.35)
    Week 28
    12.1
    (13.88)
    16.4
    (10.62)
    Week 32
    12.2
    (13.24)
    15.7
    (10.94)
    Week 36
    11.8
    (14.75)
    16.9
    (10.95)
    Week 40
    12.7
    (12.89)
    16.9
    (10.74)
    Week 44
    13.5
    (13.28)
    17.2
    (11.37)
    Week 48
    13.3
    (13.38)
    17.7
    (10.79)
    Week 52
    13.5
    (13.42)
    17.2
    (10.46)
    Week 56
    14.9
    (10.86)
    17.7
    (10.62)
    Week 60
    13.7
    (13.67)
    17.7
    (10.33)
    Week 64
    14.1
    (13.72)
    18.0
    (10.54)
    Week 68
    13.9
    (13.83)
    17.7
    (10.75)
    Week 72
    13.9
    (13.38)
    18.4
    (11.44)
    Week 76
    14.4
    (13.72)
    18.1
    (11.19)
    5. Secondary Outcome
    Title Proportion of Participants With a Gain ≥ 5, 10 and 15 Letters in BCVA by Visit Compared to Baseline
    Description The summary by visit was conducted based on the BCVA observed from each of the corresponding visits. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning. Every 5 letters represents 1 line of vision on the reading chart.
    Time Frame Baseline and every 4 weeks from baseline up to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had a valid assessment for both baseline and the corresponding post baseline visit.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 4; BCVA gain from baseline >=5
    154
    68.1%
    150
    67%
    Week 4; BCVA gain from baseline >=10
    102
    45.1%
    110
    49.1%
    Week 4; BCVA gain from baseline >=15
    64
    28.3%
    79
    35.3%
    Week 8; BCVA gain from baseline >=5
    158
    69.9%
    155
    69.2%
    Week 8; BCVA gain from baseline >=10
    117
    51.8%
    118
    52.7%
    Week 8; BCVA gain from baseline >=15
    92
    40.7%
    93
    41.5%
    Week 12; BCVA gain from baseline >=5
    156
    69%
    156
    69.6%
    Week 12; BCVA gain from baseline >=10
    114
    50.4%
    125
    55.8%
    Week 12; BCVA gain from baseline >=15
    90
    39.8%
    102
    45.5%
    Week 16; BCVA gain from baseline >=5
    127
    56.2%
    143
    63.8%
    Week 16; BCVA gain from baseline >=10
    95
    42%
    118
    52.7%
    Week 16; BCVA gain from baseline >=15
    73
    32.3%
    100
    44.6%
    Week 20; BCVA gain from baseline >=5
    119
    52.7%
    131
    58.5%
    Week 20; BCVA gain from baseline >=10
    96
    42.5%
    108
    48.2%
    Week 20; BCVA gain from baseline >=15
    74
    32.7%
    92
    41.1%
    Week 24; BCVA gain from baseline >=5
    122
    54%
    126
    56.3%
    Week 24; BCVA gain from baseline >=10
    90
    39.8%
    109
    48.7%
    Week 24; BCVA gain from baseline >=15
    75
    33.2%
    91
    40.6%
    Week 28; BCVA gain from baseline >=5
    108
    47.8%
    121
    54%
    Week 28; BCVA gain from baseline >=10
    89
    39.4%
    107
    47.8%
    Week 28; BCVA gain from baseline >=15
    75
    33.2%
    87
    38.8%
    Week 32; BCVA gain from baseline >=5
    97
    42.9%
    110
    49.1%
    Week 32; BCVA gain from baseline >=10
    79
    35%
    94
    42%
    Week 32; BCVA gain from baseline >=15
    60
    26.5%
    78
    34.8%
    Week 36; BCVA gain from baseline >=5
    100
    44.2%
    112
    50%
    Week 36; BCVA gain from baseline >=10
    81
    35.8%
    98
    43.8%
    Week 36; BCVA gain from baseline >=15
    62
    27.4%
    83
    37.1%
    Week 40; BCVA gain from baseline >=5
    96
    42.5%
    114
    50.9%
    Week 40; BCVA gain from baseline >=10
    79
    35%
    98
    43.8%
    Week 40; BCVA gain from baseline >=15
    65
    28.8%
    85
    37.9%
    Week 44; BCVA gain from baseline >=5
    94
    41.6%
    111
    49.6%
    Week 44; BCVA gain from baseline >=10
    78
    34.5%
    97
    43.3%
    Week 44; BCVA gain from baseline >=15
    64
    28.3%
    88
    39.3%
    Week 48; BCVA gain from baseline >=5
    92
    40.7%
    112
    50%
    Week 48; BCVA gain from baseline >=10
    76
    33.6%
    95
    42.4%
    Week 48; BCVA gain from baseline >=15
    61
    27%
    80
    35.7%
    Week 52; BCVA gain from baseline >=5
    87
    38.5%
    117
    52.2%
    Week 52; BCVA gain from baseline >=10
    75
    33.2%
    99
    44.2%
    Week 52; BCVA gain from baseline >=15
    64
    28.3%
    87
    38.8%
    Week 56; BCVA gain from baseline >=5
    90
    39.8%
    113
    50.4%
    Week 56; BCVA gain from baseline >=10
    76
    33.6%
    106
    47.3%
    Week 56; BCVA gain from baseline >=15
    58
    25.7%
    84
    37.5%
    Week 60; BCVA gain from baseline >=5
    86
    38.1%
    116
    51.8%
    Week 60; BCVA gain from baseline >=10
    71
    31.4%
    104
    46.4%
    Week 60; BCVA gain from baseline >=15
    62
    27.4%
    88
    39.3%
    Week 64; BCVA gain from baseline >=5
    86
    38.1%
    112
    50%
    Week 64; BCVA gain from baseline >=10
    74
    32.7%
    98
    43.8%
    Week 64; BCVA gain from baseline >=15
    58
    25.7%
    82
    36.6%
    Week 68; BCVA gain from baseline >=5
    79
    35%
    103
    46%
    Week 68; BCVA gain from baseline >=10
    67
    29.6%
    88
    39.3%
    Week 68; BCVA gain from baseline >=15
    55
    24.3%
    76
    33.9%
    Week 72; BCVA gain from baseline >=5
    68
    30.1%
    89
    39.7%
    Week 72; BCVA gain from baseline >=10
    56
    24.8%
    75
    33.5%
    Week 72; BCVA gain from baseline >=15
    45
    19.9%
    63
    28.1%
    Week 76; BCVA gain from baseline >=5
    62
    27.4%
    67
    29.9%
    Week 76; BCVA gain from baseline >=10
    52
    23%
    61
    27.2%
    Week 76; BCVA gain from baseline >=15
    43
    19%
    53
    23.7%
    6. Secondary Outcome
    Title Proportion of Participants With a Loss ≥ 5, 10 and 15 Letters in BCVA by Visit Compared to Baseline
    Description The summary by visit was conducted based on the BCVA observed from each of the corresponding visit. BCVA measurements were taken in a sitting position using Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing charts at an initial testing distance of 4 meters. Min and max possible scores are 0-100 letters read respectively. A higher score represents better visual functioning. Every 5 letters represents 1 line of vision on the reading chart.
    Time Frame Baseline and every 4 weeks from baseline up to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had a valid assessment for both baseline and the corresponding post baseline visit.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 4; BCVA loss from baseline >=5
    6
    2.7%
    7
    3.1%
    Week 4; BCVA loss from baseline >=10
    1
    0.4%
    3
    1.3%
    Week 4; BCVA loss from baseline >=15
    0
    0%
    0
    0%
    Week 8; BCVA loss from baseline >=5
    2
    0.9%
    4
    1.8%
    Week 8; BCVA loss from baseline >=10
    1
    0.4%
    2
    0.9%
    Week 8; BCVA loss from baseline >=15
    1
    0.4%
    0
    0%
    Week 12; BCVA loss from baseline >=5
    3
    1.3%
    2
    0.9%
    Week 12; BCVA loss from baseline >=10
    2
    0.9%
    1
    0.4%
    Week 12; BCVA loss from baseline >=15
    1
    0.4%
    0
    0%
    Week 16; BCVA loss from baseline >=5
    9
    4%
    4
    1.8%
    Week 16; BCVA loss from baseline >=10
    5
    2.2%
    2
    0.9%
    Week 16; BCVA loss from baseline >=15
    3
    1.3%
    2
    0.9%
    Week 20; BCVA loss from baseline >=5
    6
    2.7%
    4
    1.8%
    Week 20; BCVA loss from baseline >=10
    2
    0.9%
    3
    1.3%
    Week 20; BCVA loss from baseline >=15
    2
    0.9%
    1
    0.4%
    Week 24; BCVA loss from baseline >=5
    8
    3.5%
    3
    1.3%
    Week 24; BCVA loss from baseline >=10
    3
    1.3%
    3
    1.3%
    Week 24; BCVA loss from baseline >=15
    3
    1.3%
    1
    0.4%
    Week 28; BCVA loss from baseline >=5
    9
    4%
    2
    0.9%
    Week 28; BCVA loss from baseline >=10
    6
    2.7%
    1
    0.4%
    Week 28; BCVA loss from baseline >=15
    6
    2.7%
    1
    0.4%
    Week 32; BCVA loss from baseline >=5
    8
    3.5%
    3
    1.3%
    Week 32; BCVA loss from baseline >=10
    5
    2.2%
    2
    0.9%
    Week 32; BCVA loss from baseline >=15
    3
    1.3%
    0
    0%
    Week 36; BCVA loss from baseline >=5
    9
    4%
    2
    0.9%
    Week 36; BCVA loss from baseline >=10
    7
    3.1%
    1
    0.4%
    Week 36; BCVA loss from baseline >=15
    5
    2.2%
    1
    0.4%
    Week 40; BCVA loss from baseline >=5
    5
    2.2%
    4
    1.8%
    Week 40; BCVA loss from baseline >=10
    4
    1.8%
    1
    0.4%
    Week 40; BCVA loss from baseline >=15
    2
    0.9%
    1
    0.4%
    Week 44; BCVA loss from baseline >=5
    4
    1.8%
    5
    2.2%
    Week 44; BCVA loss from baseline >=10
    3
    1.3%
    3
    1.3%
    Week 44; BCVA loss from baseline >=15
    2
    0.9%
    2
    0.9%
    Week 48; BCVA loss from baseline >=5
    5
    2.2%
    3
    1.3%
    Week 48; BCVA loss from baseline >=10
    3
    1.3%
    1
    0.4%
    Week 48; BCVA loss from baseline >=15
    1
    0.4%
    1
    0.4%
    Week 52; BCVA loss from baseline >=5
    5
    2.2%
    2
    0.9%
    Week 52; BCVA loss from baseline >=10
    3
    1.3%
    1
    0.4%
    Week 52; BCVA loss from baseline >=15
    2
    0.9%
    1
    0.4%
    Week 56; BCVA loss from baseline >=5
    3
    1.3%
    3
    1.3%
    Week 56; BCVA loss from baseline >=10
    1
    0.4%
    1
    0.4%
    Week 56; BCVA loss from baseline >=15
    0
    0%
    0
    0%
    Week 60; BCVA loss from baseline >=5
    7
    3.1%
    2
    0.9%
    Week 60; BCVA loss from baseline >=10
    3
    1.3%
    0
    0%
    Week 60; BCVA loss from baseline >=15
    1
    0.4%
    0
    0%
    Week 64; BCVA loss from baseline >=5
    5
    2.2%
    2
    0.9%
    Week 64; BCVA loss from baseline >=10
    1
    0.4%
    1
    0.4%
    Week 64; BCVA loss from baseline >=15
    1
    0.4%
    1
    0.4%
    Week 68; BCVA loss from baseline >=5
    6
    2.7%
    3
    1.3%
    Week 68; BCVA loss from baseline >=10
    3
    1.3%
    1
    0.4%
    Week 68; BCVA loss from baseline >=15
    1
    0.4%
    0
    0%
    Week 72; BCVA loss from baseline >=5
    1
    0.4%
    2
    0.9%
    Week 72; BCVA loss from baseline >=10
    1
    0.4%
    2
    0.9%
    Week 72; BCVA loss from baseline >=15
    1
    0.4%
    1
    0.4%
    Week 76; BCVA loss from baseline >=5
    2
    0.9%
    2
    0.9%
    Week 76; BCVA loss from baseline >=10
    1
    0.4%
    0
    0%
    Week 76; BCVA loss from baseline >=15
    1
    0.4%
    0
    0%
    7. Secondary Outcome
    Title Change From Baseline in CSFT Averaged Over Week 40 to Week 52
    Description Change from baseline in central subfield thickness (CSFT) averaged over Week 40 to Week 52 , measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)
    Time Frame Baseline, Week 40 to Week 52

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had at least one CSFT assessment on scheduled visits over the corresponding time point
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 123 132
    Mean (Standard Deviation) [µm]
    -231.8
    (188.97)
    -259.2
    (190.69)
    8. Secondary Outcome
    Title Change From Baseline in CSFT Averaged Over Week 64 to Week 76
    Description Change from baseline in central subfield thickness (CSFT) averaged over Week 64 to Week 76, measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)
    Time Frame Baseline, Week 64 to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had at least one CSFT assessment on scheduled visits over the corresponding time point
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 110 121
    Mean (Standard Deviation) [µm]
    -243.6
    (201.61)
    -272.6
    (194.29)
    9. Secondary Outcome
    Title Change From Baseline in CSFT by Visit up to Week 76
    Description Change from baseline in central subfield thickness (CSFT) measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)
    Time Frame Baseline, and every 4 weeks from baseline up to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had CSFT data available on baseline and the specific post-baseline visit.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 4
    -247.1
    (197.99)
    -259.4
    (185.11)
    Week 8
    -255.9
    (206.00)
    -270.7
    (195.49)
    Week 12
    -264.5
    (208.70)
    -271.9
    (194.99)
    Week 16
    -271.1
    (209.38)
    -276.1
    (209.70)
    Week 20
    -257.1
    (197.31)
    -285.2
    (210.32)
    Week 24
    -254.9
    (203.29)
    -286.6
    (207.67)
    Week 28
    -245.4
    (197.62)
    -263.6
    (197.11)
    Week 32
    -231.1
    (208.02)
    -262.1
    (193.80)
    Week 36
    -234.1
    (199.02)
    -260.8
    (195.03)
    Week 40
    -224.7
    (190.50)
    -259.0
    (189.01)
    Week 44
    -242.8
    (197.34)
    -264.1
    (192.06)
    Week 48
    -237.1
    (200.64)
    -279.4
    (193.41)
    Week 52
    -243.0
    (203.87)
    -263.4
    (190.36)
    Week 56
    -249.2
    (206.54)
    -271.4
    (198.09)
    Week 60
    -238.3
    (185.78)
    -265.3
    (187.29)
    Week 64
    -249.8
    (207.86)
    -266.1
    (199.79)
    Week 68
    -247.5
    (217.61)
    -261.1
    (192.30)
    Week 72
    -253.4
    (211.06)
    -279.4
    (185.21)
    Week 76
    -255.6
    (184.22)
    -283.7
    (197.29)
    10. Secondary Outcome
    Title Proportion of Subjects With Presence of Retinal Fluid (Intra- and/or Subretinal Fluid) in the Study Eye by Visit up to Week 76
    Description Presence of retinal fluid (intra- and/or subretinal fluid) assessed by Spectral Domain Optical Coherence Tomography (SD-OCT)
    Time Frame Every 4 weeks from baseline up to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had data at each time point
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 4
    83
    36.7%
    101
    45.1%
    Week 8
    56
    24.8%
    68
    30.4%
    Week 12
    41
    18.1%
    49
    21.9%
    Week 16
    34
    15%
    50
    22.3%
    Week 20
    33
    14.6%
    45
    20.1%
    Week 24
    35
    15.5%
    42
    18.8%
    Week 28
    47
    20.8%
    56
    25%
    Week 32
    58
    25.7%
    50
    22.3%
    Week 36
    48
    21.2%
    57
    25.4%
    Week 40
    42
    18.6%
    56
    25%
    Week 44
    43
    19%
    54
    24.1%
    Week 48
    44
    19.5%
    49
    21.9%
    Week 52
    34
    15%
    57
    25.4%
    Week 56
    34
    15%
    54
    24.1%
    Week 60
    39
    17.3%
    63
    28.1%
    Week 64
    31
    13.7%
    52
    23.2%
    Week 68
    34
    15%
    52
    23.2%
    Week 72
    33
    14.6%
    39
    17.4%
    Week 76
    16
    7.1%
    38
    17%
    11. Secondary Outcome
    Title Proportion of Subjects With a CSFT < 300 µm for the Study Eye by Visit up to Week 76
    Description Central subfield thickness (CSFT) is measured in µm by Spectral Domain Optical Coherence Tomography (SD-OCT)
    Time Frame Every 4 weeks from Week 4 up to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had non-missing CSFT assessment at the corresponding visit
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 4
    167
    73.9%
    153
    68.3%
    Week 8
    172
    76.1%
    166
    74.1%
    Week 12
    156
    69%
    155
    69.2%
    Week 16
    137
    60.6%
    131
    58.5%
    Week 20
    120
    53.1%
    118
    52.7%
    Week 24
    127
    56.2%
    114
    50.9%
    Week 28
    109
    48.2%
    103
    46%
    Week 32
    92
    40.7%
    97
    43.3%
    Week 36
    96
    42.5%
    91
    40.6%
    Week 40
    94
    41.6%
    92
    41.1%
    Week 44
    95
    42%
    93
    41.5%
    Week 48
    89
    39.4%
    97
    43.3%
    Week 52
    86
    38.1%
    95
    42.4%
    Week 56
    86
    38.1%
    91
    40.6%
    Week 60
    83
    36.7%
    90
    40.2%
    Week 64
    85
    37.6%
    90
    40.2%
    Week 68
    82
    36.3%
    79
    35.3%
    Week 72
    70
    31%
    76
    33.9%
    Week 76
    59
    26.1%
    59
    26.3%
    12. Secondary Outcome
    Title Number of Injections Between Week 24 and Week 52 and Between Week 24 and Week 72
    Description Number of administered injections during the individualized flexible treatment (IFT) period, between Week 24 and Week 52 and between Week 24 and Week 72 are presented
    Time Frame Week 24 to Week 52 and Week 24 to Week 72

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who were on study treatment until week 52 and until week 72.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 111 126
    Between Week 24 and Week 52
    2.2
    (1.69)
    2.5
    (2.17)
    Between Week 24 and Week 72
    3.2
    (2.54)
    4.0
    (3.28)
    13. Secondary Outcome
    Title Time to Recurrence After Week 20 and up to Week 76
    Description Recurrence is defined as the need for injection while showing a lack of disease stability for the first time after Week 20 and up to Week 76. For subjects with recurrence after the Week 20 visit, time-to-event is calculated as (first time with the lack of disease stability - the injection date on Week 20 visit + 1). For subjects without recurrence after Week 20, the censoring time will be calculated as (last visit with disease stability assessment - the injection date on Week 20 visit + 1).
    Time Frame Week 20 to Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed is the number of subjects from the FAS who did not discontinue from study treatment on or before Week 20.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 157 159
    Median (95% Confidence Interval) [Weeks]
    12.9
    13.1
    14. Secondary Outcome
    Title Number of Subjects With Ocular and Non-ocular AEs up to Week 52 and Week 76
    Description Number of subjects with at least one ocular or non-ocular Adverse Events (AEs).
    Time Frame Baseline to Week 76

    Outcome Measure Data

    Analysis Population Description
    Safety Analysis Set (SAF) included all subjects who received at least one intravitreal injection.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Ocular AEs up to week 52
    93
    41.2%
    72
    32.1%
    Non-Ocular AEs up to week 52
    94
    41.6%
    112
    50%
    Ocular AEs up to week 76
    98
    43.4%
    75
    33.5%
    Non-Ocular AEs up to week 76
    103
    45.6%
    120
    53.6%
    15. Secondary Outcome
    Title Change From Baseline in Patient Reported Outcomes (NEI VFQ-25) at Week 24, Week 52 and Week 76
    Description The National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) measures a patient's subjective assessment of vision-related Quality of Life (QoL). The 11 subscales in the VFQ-25 are general vision, ocular pain, near activities, distance activities, social functioning, mental health, role difficulties, dependency, driving, color vision, and peripheral vision. The scores on the subscales were added together for a total score, which ranged from 0 to 100. A higher score indicated better vision-related quality of life.
    Time Frame Baseline, Week 24, Week 52 and Week 76

    Outcome Measure Data

    Analysis Population Description
    FAS-observed: The overall number of participants analyzed is the Full Analysis Set (FAS) that included all randomized subjects who received at least one intravitreal injection of the study treatment. The number analyzed per row is the number of subjects from the FAS who had NEI VFQ-25 assessment on scheduled visits.
    Arm/Group Title Brolucizumab 6 mg Aflibercept 2 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT) 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226 224
    Week 24
    5.6
    (11.51)
    6.4
    (11.92)
    Week 52
    6.9
    (13.21)
    7.6
    (10.47)
    Week 76
    8.6
    (13.89)
    7.5
    (11.55)
    16. Secondary Outcome
    Title Number of Subjects According to Their Anti-drug Antibody (ADA) Titer at Screening and Week 4, Week 12, Week 24, Week 36, Week 52 and Week 76
    Description Anti-drug antibodies (ADA) levels were assessed from subjects assigned to brolucizumab treatment only.
    Time Frame Baseline, Week 4, Week 12, Week 24, Week 36, Week 52 and Week 76

    Outcome Measure Data

    Analysis Population Description
    SAF-observed: Safety Analysis Set (SAF) included all subjects who received at least one intravitreal injection with brolucizumab. The number analyzed is the number of subjects from the SAF who had a value for ADA status on scheduled visits.
    Arm/Group Title Brolucizumab 6 mg
    Arm/Group Description 1 intravitreal injection every 4 weeks for a total of 6 injections, followed by 48 weeks of individualized flexible treatment (IFT)
    Measure Participants 226
    Negative
    67
    29.6%
    40
    29
    12.8%
    120
    33
    14.6%
    360
    37
    16.4%
    1080
    31
    13.7%
    3240
    15
    6.6%
    9720
    1
    0.4%
    29200
    6
    2.7%
    Negative
    76
    33.6%
    40
    29
    12.8%
    120
    31
    13.7%
    360
    28
    12.4%
    1080
    27
    11.9%
    3240
    9
    4%
    9720
    6
    2.7%
    29200
    2
    0.9%
    Negative
    58
    25.7%
    40
    17
    7.5%
    120
    31
    13.7%
    360
    25
    11.1%
    1080
    19
    8.4%
    3240
    11
    4.9%
    9720
    7
    3.1%
    29200
    2
    0.9%
    Negative
    44
    19.5%
    40
    14
    6.2%
    120
    23
    10.2%
    360
    17
    7.5%
    1080
    19
    8.4%
    3240
    11
    4.9%
    9720
    5
    2.2%
    29200
    1
    0.4%
    Negative
    33
    14.6%
    40
    18
    8%
    120
    19
    8.4%
    360
    17
    7.5%
    1080
    17
    7.5%
    3240
    8
    3.5%
    9720
    1
    0.4%
    29200
    1
    0.4%
    Negative
    28
    12.4%
    40
    18
    8%
    120
    19
    8.4%
    360
    16
    7.1%
    1080
    14
    6.2%
    3240
    5
    2.2%
    9720
    1
    0.4%
    29200
    0
    0%
    Negative
    17
    7.5%
    40
    6
    2.7%
    120
    18
    8%
    360
    14
    6.2%
    1080
    10
    4.4%
    3240
    2
    0.9%
    9720
    1
    0.4%
    29200
    0
    0%

    Adverse Events

    Time Frame Adverse events were collected from first dose of study treatment until end of study treatment plus 4 weeks post treatment, up to maximum duration of 76 weeks
    Adverse Event Reporting Description Any sign or symptom that occurs during the study treatment plus the 4 weeks post treatment
    Arm/Group Title Brolucizumab 6mg Aflibercept 2mg Overall
    Arm/Group Description Brolucizumab 6mg Aflibercept 2mg Overall
    All Cause Mortality
    Brolucizumab 6mg Aflibercept 2mg Overall
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/226 (0%) 2/224 (0.9%) 2/450 (0.4%)
    Serious Adverse Events
    Brolucizumab 6mg Aflibercept 2mg Overall
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 32/226 (14.2%) 16/224 (7.1%) 48/450 (10.7%)
    Blood and lymphatic system disorders
    Anaemia 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Cardiac disorders
    Angina pectoris 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Atrial fibrillation 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Cardiac arrest 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Cardiac failure 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Cardiac failure congestive 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Cardiac valve disease 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Myocardial infarction 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Palpitations 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Congenital, familial and genetic disorders
    Atrial septal defect 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Ear and labyrinth disorders
    Vertigo 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Eye disorders
    Cataract - Fellow eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Cataract - Study eye 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    Glaucoma - Fellow eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Glaucoma - Study eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Iridocyclitis - Study eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Retinal aneurysm - Study eye 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Retinal artery occlusion - Fellow eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Retinal artery occlusion - Study eye 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    Retinal detachment - Study eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Retinal occlusive vasculitis - Study eye 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    Retinal vascular occlusion - Study eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Retinal vasculitis - Study eye 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    Uveitis - Study eye 3/226 (1.3%) 0/224 (0%) 3/450 (0.7%)
    Vitreous haemorrhage - Study eye 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Vitreous opacities - Study eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Vitritis - Study eye 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Gastrointestinal disorders
    Mallory-Weiss syndrome 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Pancreatitis acute 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    General disorders
    Chest pain 1/226 (0.4%) 1/224 (0.4%) 2/450 (0.4%)
    Hepatobiliary disorders
    Cholecystitis acute 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Infections and infestations
    Bronchitis 1/226 (0.4%) 1/224 (0.4%) 2/450 (0.4%)
    COVID-19 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    COVID-19 pneumonia 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Endophthalmitis - Study eye 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    Injury, poisoning and procedural complications
    Dislocation of vertebra 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Fall 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Subdural haemorrhage 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Investigations
    Weight increased 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Musculoskeletal and connective tissue disorders
    Muscular weakness 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Osteoarthritis 1/226 (0.4%) 1/224 (0.4%) 2/450 (0.4%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bladder neoplasm 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Eyelid seborrhoeic keratosis - Fellow eye 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Prostate cancer 2/226 (0.9%) 0/224 (0%) 2/450 (0.4%)
    Nervous system disorders
    Cerebral infarction 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Cerebrovascular accident 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Ischaemic stroke 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Syncope 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Transient ischaemic attack 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Product Issues
    Device dislocation 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Psychiatric disorders
    Depression 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Renal and urinary disorders
    Urinary retention 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Reproductive system and breast disorders
    Benign prostatic hyperplasia 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Respiratory, thoracic and mediastinal disorders
    Pleural mass 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Vascular disorders
    Aortic stenosis 1/226 (0.4%) 0/224 (0%) 1/450 (0.2%)
    Vasospasm 0/226 (0%) 1/224 (0.4%) 1/450 (0.2%)
    Other (Not Including Serious) Adverse Events
    Brolucizumab 6mg Aflibercept 2mg Overall
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 109/226 (48.2%) 95/224 (42.4%) 204/450 (45.3%)
    Eye disorders
    Cataract - Study eye 9/226 (4%) 2/224 (0.9%) 11/450 (2.4%)
    Conjunctival haemorrhage - Study eye 11/226 (4.9%) 12/224 (5.4%) 23/450 (5.1%)
    Dry eye - Fellow eye 5/226 (2.2%) 9/224 (4%) 14/450 (3.1%)
    Dry eye - Study eye 6/226 (2.7%) 9/224 (4%) 15/450 (3.3%)
    Eye pain - Study eye 4/226 (1.8%) 11/224 (4.9%) 15/450 (3.3%)
    Foreign body sensation in eyes - Study eye 5/226 (2.2%) 1/224 (0.4%) 6/450 (1.3%)
    Macular oedema - Study eye 15/226 (6.6%) 10/224 (4.5%) 25/450 (5.6%)
    Retinal exudates - Study eye 5/226 (2.2%) 8/224 (3.6%) 13/450 (2.9%)
    Retinal haemorrhage - Study eye 2/226 (0.9%) 8/224 (3.6%) 10/450 (2.2%)
    Uveitis - Study eye 5/226 (2.2%) 0/224 (0%) 5/450 (1.1%)
    Visual acuity reduced - Study eye 15/226 (6.6%) 12/224 (5.4%) 27/450 (6%)
    Vitreous detachment - Study eye 5/226 (2.2%) 5/224 (2.2%) 10/450 (2.2%)
    Vitreous floaters - Study eye 11/226 (4.9%) 5/224 (2.2%) 16/450 (3.6%)
    Vitreous opacities - Study eye 5/226 (2.2%) 1/224 (0.4%) 6/450 (1.3%)
    Vitritis - Study eye 5/226 (2.2%) 0/224 (0%) 5/450 (1.1%)
    Gastrointestinal disorders
    Toothache 5/226 (2.2%) 3/224 (1.3%) 8/450 (1.8%)
    Infections and infestations
    COVID-19 7/226 (3.1%) 7/224 (3.1%) 14/450 (3.1%)
    Nasopharyngitis 6/226 (2.7%) 7/224 (3.1%) 13/450 (2.9%)
    Upper respiratory tract infection 2/226 (0.9%) 7/224 (3.1%) 9/450 (2%)
    Urinary tract infection 5/226 (2.2%) 6/224 (2.7%) 11/450 (2.4%)
    Injury, poisoning and procedural complications
    Fall 3/226 (1.3%) 5/224 (2.2%) 8/450 (1.8%)
    Investigations
    Intraocular pressure increased - Fellow eye 3/226 (1.3%) 6/224 (2.7%) 9/450 (2%)
    Intraocular pressure increased - Study eye 4/226 (1.8%) 8/224 (3.6%) 12/450 (2.7%)
    Metabolism and nutrition disorders
    Hypercholesterolaemia 5/226 (2.2%) 3/224 (1.3%) 8/450 (1.8%)
    Type 2 diabetes mellitus 5/226 (2.2%) 0/224 (0%) 5/450 (1.1%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 2/226 (0.9%) 6/224 (2.7%) 8/450 (1.8%)
    Back pain 2/226 (0.9%) 7/224 (3.1%) 9/450 (2%)
    Osteoarthritis 6/226 (2.7%) 2/224 (0.9%) 8/450 (1.8%)
    Nervous system disorders
    Dizziness 4/226 (1.8%) 7/224 (3.1%) 11/450 (2.4%)
    Vascular disorders
    Hypertension 26/226 (11.5%) 19/224 (8.5%) 45/450 (10%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (ie, data from all sites) in the clinical trial.

    Results Point of Contact

    Name/Title Study Director
    Organization Novartis Pharmaceuticals
    Phone 862-778-8300
    Email novartis.email@novartis.com
    Responsible Party:
    Novartis Pharmaceuticals
    ClinicalTrials.gov Identifier:
    NCT03802630
    Other Study ID Numbers:
    • CRTH258C2301
    • 2018-001842-33
    First Posted:
    Jan 14, 2019
    Last Update Posted:
    Jul 28, 2022
    Last Verified:
    Jun 1, 2022