Journal of Clinical Medicine Article Real-World Experience with Brolucizumab in Wet Age-Related Macular Degeneration: The REBA Study Alper Bilgic 1 , Laurent Kodjikian 2,3 , Francesc March de Ribot 4 , Vaishali Vasavada 5 , Jesus H. Gonzalez-Cortes 6 , Amro Abukashabah 2,7 , Aditya Sudhalkar 1,8, * and Thibaud Mathis 2,3   Citation: Bilgic, A.; Kodjikian, L.; March de Ribot, F.; Vasavada, V.; Gonzalez-Cortes, J.H.; Abukashabah, A.; Sudhalkar, A.; Mathis, T. Real-World Experience with Brolucizumab in Wet Age-Related Macular Degeneration: The REBA Study. J. Clin. Med. 2021, 10, 2758. https://doi.org/10.3390/ jcm10132758 Academic Editors: María Isabel López-Gálvez and Margaret M. DeAngelis Received: 31 May 2021 Accepted: 23 June 2021 Published: 23 June 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Alphavision Augenarztpraxis, 27568 Bremerhaven, Germany; drbilgicalper@yahoo.com 2 Service d’Ophtalmologie, Centre Hospitalier Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, 69004 Lyon, France; laurent.kodjikian@chu-lyon.fr (L.K.); dr.heartaaa@hotmail.com (A.A.); thibaud.mathis@chu-lyon.fr (T.M.) 3 UMR-CNRS 5510, Matéis, Villeurbane, 69004 Lyon, France 4 Department of Ophthalmology, Universitat Autonoma de Barcelona, 08003 Barcelona, Spain; marchfrancesc@gmail.com 5 Raghudeep Eye Hospital, Ahmedabad 380054, India; vaishali@raghudeepeyeclinic.com 6 Department of Ophthalmology, Universitat Autonoma de Ciudad, Mexico City 06720, Mexico; drjesusgzz@gmail.com 7 Ophthalmology Department, King Abdulaziz University, Rabigh 25732, Saudi Arabia 8 MS Sudhalkar Medical Research Foundation, Baroda 390001, India * Correspondence: adityasudhalkar@yahoo.com; Tel.: +91-265-279-3799 Abstract: The aim of the present study was to determine the efficacy and safety of intravitreal brolucizumab therapy for neovascular age-related macular degeneration (AMD) in the real-world setting. The REBA study (real-world experience with brolucizumab in wet AMD) was a retrospective, observational, multicentric study that included 78 consecutive patients (105 eyes), with neovascular AMD, who received brolucizumab therapy. Both treatment-naive and switch-therapy patients were included. Switch therapy was based either on fluid recurrence, fluid recalcitrance, or inability to extend beyond q4/q6. All relevant data were collected. The primary outcome measure was change in best-corrected visual acuity (BCVA) over time. Secondary outcome measures included determination of change in central subfield thickness (CST) and complications. The mean baseline BCVA was 49.4 ± 5.4 letters and 40 ± 3.2 letters, and corresponding mean BCVA gain was +11.9 ± 3.9 letters (p = 0.011) and +10.4 ± 4.8 letters (p = 0.014) in the treatment-naive and switch-therapy groups, respectively. The change in CST was significantly decreased in the treatment-naive (p = 0.021) and the switch-therapy (p = 0.013) groups. The mean follow-up was 10.4 months in both groups. One patient in the switch-therapy group developed vascular occlusion and another a macular hole after the fifth brolucizumab injection. Both patients recovered uneventfully. In conclusion, patients showed a very good anatomical and functional response to brolucizumab therapy in the real world, regardless of prior treatment status, until the end of the follow-up period. Two significant untoward events were noted. Keywords: age-related macular degeneration; anti-vascular endothelial growth factor; brolucizumab; exudation; switch therapy 1. Introduction Anti-vascular endothelial growth factor (VEGF) agents have been established as the treatment of choice for neovascular age-related macular degeneration (AMD) [1,2]. Monthly injections are rather impractical and negate functional benefits through intense follow-up schedules. There are psychological and physical consequences [3] due to the strict schedules and the potential threat of geographic atrophy (although it rarely, if ever, manifests) [4]. One way to reduce the number of treatments is infrequent injections (e.g., pro re nata injections, or some manner of treat-and-inject regimen) [5–9] without compromise J. Clin. Med. 2021, 10, 2758. https://doi.org/10.3390/jcm10132758 https://www.mdpi.com/journal/jcm