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Expert Interview

Slingshot members are talking to an expert! The topic is:

Looking at the evolving landscape in Wet AMD, with focus on brolucizumab, ahead of its launch in late 2019

Ticker(s): NVS, REGN

Who's the expert?

Name: Dr Sandra Montezuma - MD

Institution: University of Minnesota

  • Associate Professor in Ophthalmology at the University of Minnesota & Speaker for Novartis.
  • Treats 20-30 patients a week with Wet AMD; subspecialty expertise in providing medical and surgical care for all retina diseases in adults and children. 
  • Research interest includes translational research in Age-Related Macular Degeneration, angiogenesis, Inherited Retinal Diseases, retinal implants, and retinal prosthesis. 

Interview Questions

  • Please tell us about your clinical practice, background in treating Wet AMD and research in the space. 
  • How many patients do you treat,what is the first line of therapy? 
  • What % of patients do not respond well?

Added By: slingshot_insights

  • How much of a need for new treatments is there for this condition?
  • Which drugs get prescribed most often and under what specific circumstances?

Added By: slingshot_insights

  • What are the Inflammatory Mechanisms of AMD?
  • How does Brolucizumab inhibit the activation of VEGF receptors/ block the ligand-receptor interaction?
  • Why are humanized single-chain antibody fragment (scFv) attractive candidates for targeted immunotherapy?

Added By: slingshot_insights

What experience do you have with Topical bromfenac and intravitreal triamcinolone in conjunction with anti-VEGF intravitreal injections? Pros and cons?

Added By: slingshot_insights

  • In the two-year HAWK and HARRIER study, brolucizumab demonstrated non-inferiority versus Eylea (aflibercept) in best-corrected visual acuity, and exhibited superiority in key retinal outcomes at 48 weeks and superiority at 96 weeks in the reduction of retinal fluid and reductions in central subfield thickness. [24% for brolucizumab 6 mg vs. 37% for aflibercept in HAWK; 24% vs. 39%, respectively, in HARRIER] 
  • Given those results, how likely would you be to switch your patients to brolucizumab after approval?

Added By: slingshot_insights

  • Absolute reductions in CST from baseline were -175 µm for brolucizumab 6 mg vs -149 µm for aflibercept in HAWK and -198 µm versus -155 µm in HARRIER. 
  • How much would those numbers translate to an improvement on the patients’ outcomes?

Added By: slingshot_insights

How popular has Eylea become in clinicians' offices due to its 8-week dosing regimen, since its approval in 2018?

Added By: slingshot_insights

82% of patients in HAWK and 75 percent in HARRIER Brolucizumab studies were maintained on a 12-week dosing interval in year two, after one year on a 12-week dosing interval. How does this dosing interval and stability compare to other choices you might have?

Added By: slingshot_insights

What % of the patients usually receive Eylea (aflibercept) and what are some common reasons for which alternatives are considered instead?

Added By: slingshot_insights

what does the doc think about the latest phase 2b trial in 366 patients from Opthea which shows that pan VEGF inhibition (also blocking also VEGF C/D) showed for the first time using the same VEGF validated pathway there can be better efficacy from a VEGF A blocker alone (brolu, eylea, lucentis) adding 3.4 letters ontop and over 6+ letters in occult lesions

Added By: user282f0563

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