New Release: Alpha testing version has been released.

Brolucizumab

S01L - Ocular vascular disorder agents ATC S01LA06 Antibody approved 2019 Parenteral

JFDA label: Beovu Solution for injection in Pre-filled Syringe

Mechanism of Action

Inhibitor of Vascular endothelial growth factor A, long form — Vascular endothelial growth factor A inhibitor

TargetActionGene / class
Vascular endothelial growth factor A, long form efficacy INHIBITOR VEGFA · Secreted protein

Indications

Approved

  • Retinal Neovascularization — ocular vascular disease
  • Wet Macular Degeneration — wet macular degeneration

Off-label

  • Choroidal Neovascularization
  • Macular Degeneration
  • Macular Edema
  • Retinal Vein Occlusion

Contraindications

Source: openFDA

  • Ocular or Periocular Infections ( 4.1 ) Active Intraocular Inflammation ( 4.2 ) Hypersensitivity ( 4.3 ) 4.1 Ocular or Periocular Infections BEOVU is contraindicated in patients with ocular or periocular infections. 4.2 Active Intraocular Inflammation BEOVU is contraindicated in patients with active intraocular inflammation. 4.3 Hypersensitivity BEOVU is contraindicated in patients with known hypersensitivity to brolucizumab or any of the excipients in BEOVU. Hypersensitivity reactions may manifest as rash, pruritus, urticaria, erythema, or severe intraocular inflammation. Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Vascular disorders (1)

Not Known Conjunctival Hemorrhage

Eye disorders (2)

Not Known Eye Pain · Visual Acuity Reduced

General disorders and administration site conditions (1)

Not Known Cataract

Dosing

Source: openFDA

Neovascular (Wet) Age-Related Macular Degeneration (AMD) The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) monthly (approximately every 25-31 days) for the first three doses, followed by one dose of 6 mg (0.05 mL) every 8-12 weeks ( 2.2 ). Diabetic Macular Edema (DME) The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) every six weeks (approximately every 39-45 days) for the first five doses, followed by one dose of 6 mg (0.05 mL of 120 mg/mL solution) every 8-12 weeks ( 2.3 ). 2.1 General Dosing Information For ophthalmic intravitreal injection. BEOVU must be administered by a qualified physician. BEOVU is available packaged as follows [see How Supplied/Storage and Handling (16)] : Pre-filled Syringe Vial kit with injection components (vial, filter needle) 2.2 Neovascular (Wet) Age-Related Macular Degeneration (AMD) The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) administered by intravitreal injection monthly (approximately every 25 to 31 days) for the first three doses, followed by 6 mg (0.05 mL) by intravitreal injection once every 8 to 12 weeks. 2.3 Diabetic Macular Edema (DME) The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) administered by intravitreal injection every six weeks (approximately every 39-45 days) for the first five doses, followed by 6 mg (0.05 mL) by intravitreal injection once every 8-12 weeks. 2.4 Preparation for Administration – Pre-filled Syringe and Vial Store BEOVU in the refrigerator between 2°C to 8°C (36°F to 46°F); do not freeze. Keep BEOVU in the outer carton to protect from light. Prior to use, the unopened glass vial or sealed blister pack of BEOVU may be kept at room temperature, 20°C to 25°C (68°F to 77°F) for up to 24 hours. After opening, proceed under aseptic conditions. BEOVU is a clear to slightly opalescent and colorless to slightly brownish-yellow solution. BEOVU should be inspected visually upon removal from the refrigerator and prior to administration. If particulates, cloudiness, or discoloration are visible, the BEOVU must not be used. Use aseptic technique for preparation of the intravitreal injection. Pre-filled Syringe The BEOVU pre-filled glass syringe is sterile and for the treatment of a single eye. It should be inspected visually prior to administration. Do not use if the packaging, or pre-filled syringe are opened, damaged, or expired [see How Supplied/Storage and Handling (16)] . STEP 1: PREPARE Peel the lid off the blister package and, using aseptic technique, remove the sterile syringe. STEP 2: SNAP OFF SYRINGE CAP Snap off the syringe cap and dispose of it (see Figure 1). Do not turn or twist the syringe cap. Figure 1: STEP 3: ATTACH INJECTION NEEDLE Aseptically and firmly assemble a 30-gauge x ½ inch sterile injection needle (not included) onto the Luer lock syringe. STEP 4: DISLODGE AIR BUBBLES To check for air bubbles, hold the syringe with the needle pointing up. If there are any air bubbles, gently tap the syringe with your finger until the bubbles rise to the top (see Figure 2). Carefully remove the needle cap by pulling it straight off. Figure 2: STEP 5: EXPEL AIR AND SET THE DOSE Hold the syringe at eye level and carefully push the plunger until the edge below the dome of the rubber stopper is aligned with the 0.05 mL dose mark (see Figure 3). This will expel the air and the excess liquid and set the dose to the 0.05 mL dose mark. The syringe is ready for the injection. Figure 3: Vial The BEOVU vial kit includes the sterile glass vial and filter needle which are sterile and for the treatment of a single eye. It should be inspected visually prior to administration. Do not use if the packaging, vial, and/or filter needle are damaged or expired [see How Supplied/Storage and Handling (16)] . STEP 1: Gather the supplies needed. One BEOVU vial (included) One sterile 5-micron blunt filter needle (18-gauge x 1½ inch, 1.2 mm x 40 mm) (included) One sterile 30-gauge x ½ inch injection ne

Warnings & Precautions

Source: openFDA

Warnings & Precautions

Endophthalmitis and retinal detachment may occur following intravitreal injections. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay ( 5.1 ). Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported following BEOVU injections. Patients should be instructed to report any change in vision without delay ( 5.2 ). Increases in intraocular pressure (IOP) have been seen within 30 minutes of an intravitreal injection ( 5.3 ). There is a potential risk of arterial thromboembolic events (ATE) following intravitreal use of VEGF inhibitors ( 5.4 ).

Endophthalmitis and Retinal Detachment Intravitreal injections, includ

Endophthalmitis and Retinal Detachment Intravitreal injections, including those with BEOVU, have been associated with endophthalmitis and retinal detachment [see Contraindications (4.1) and Adverse Reactions (6.1)] . Proper aseptic injection techniques must always be used when administering BEOVU. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately [see Dosage and Administration (2.4) and Patient Counseling Information (17)] .

Retinal Vasculitis and/or Retinal Vascular Occlusion Retinal vasculiti

Retinal Vasculitis and/or Retinal Vascular Occlusion Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported with the use of BEOVU. These immune-mediated adverse events may occur following the first intravitreal injection. Discontinue treatment with BEOVU in patients who develop these events. Patients treated with BEOVU who experience intraocular inflammation may be at risk of developing retinal vasculitis and/or retinal vascular occlusion and should be closely monitored [see Contraindications (4.2) and Adverse Reactions (6.1, 6.2)] . Patients should be instructed to report any change in vision without delay.

Increase in Intraocular Pressure Acute increases in intraocular pressu

Increase in Intraocular Pressure Acute increases in intraocular pressure (IOP) have been seen within 30 minutes of intravitreal injection, including with BEOVU [see Adverse Reactions (6.1)] . Sustained IOP increases have also been reported. Both IOP and perfusion of the optic nerve head must be monitored and managed appropriately [see Dosage and Administration (2.4)] .

Thromboembolic Events Although there was a low rate of arterial thromb

Thromboembolic Events Although there was a low rate of arterial thromboembolic events (ATEs) observed in the BEOVU clinical trials, there is a potential risk of ATEs following intravitreal use of VEGF inhibitors. Arterial thromboembolic events are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause). The ATE rate in the two controlled 96-week neovascular AMD studies (HAWK and HARRIER) during the first 96 weeks was 4.5% (33 of 730) in the pooled brolucizumab arms compared with 4.7% (34 of 729) in the pooled aflibercept arms [see Clinical Studies (14.1)] .

Pregnancy & Lactation

Lactation

No Data Hale L3

The manufacturer states that breastfeeding is not recommended during treatment and for at least one month after the last dose.

Registered Products (1)

BrandForm / strengthPackAgentCitizen (JOD)
Beovu Solution for injection in Pre-filled Syringe Injection 120 mg/1 ml 1 PFS The Jordan Drugstore Co