Key Points
- RAPTOR was a phase 3 study comparing intravitreal brolucizumab 6mg to aflibercept 2mg in patients with macular edema due to BRVO.
- The study was terminated by the sponsor due to increased incidence of retinal vasculitis and retinal vascular occlusion in patients dosed brolucizumab 6mg every 4 weeks beyond 3 initial doses.
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Objective
To evaluate brolucizumab 6mg versus aflibercept 2mg in patients with visual impairment due to macular edema secondary to branch retinal vein occlusion (BRVO).
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Study Design
Phase 3 randomized clinical trial. Duration: 18 months.
Subjects
- Inclusion criteria:
- Visual impairment due to macular edema secondary to BRVO diagnosed less than 6 months prior to screening
- BCVA 78–23 letters (approx. 20/32 to 20/320)
- Exclusion criteria:
- Ocular disorders in the study eye that prevent response to or assessment of study treatment (including significant diabetic retinopathy)
- Active intraocular inflammation in study eye
- Uncontrolled glaucoma in the study eye (IOP>25mmHg on medication)
- Previous anti-VEGF, intraocular/periocular steroids, macular/peripheral laser photocoagulation within 3 months prior to baseline
- Intraocular surgery within 3 months prior to baseline
- Vitreoretinal surgery
Randomization Scheme/Study Interventions
- After 6 initial monthly injections with intravitreal brolucizumab 6mg or aflibercept 2mg (loading phase), subjects entered a one-year individualized flexible treatment (IFT) phase.
- During the IFT phase, disease stability was assessed monthly and subjects received either an active or sham injection.
Results
- The study was terminated by the sponsor due to increased incidences of intraocular inflammation, including retinal vasculitis and retinal vascular occlusion, in patients dosed brolucizumab 6mg every 4 weeks beyond 3 initial doses.
- Prior to termination, there were two cases of reported retinal artery occlusion and retinal vasculitis (2/226 eyes, 0.88%) in the brolucizumab group, compared to none in the aflibercept group.
Conclusions
- RAPTOR was a phase 3 study comparing intravitreal brolucizumab 6mg to aflibercept 2mg in patients with macular edema due to BRVO.
- The study was terminated due to increased incidence of intraocular inflammation, including retinal vasculitis and retinal vascular occlusion, in patients dosed brolucizumab 6mg every 4 weeks beyond 3 initial doses.