Beovu, also known as brolucizumab-dbll, is a prescription injection that treats neovascular (wet) age-related macular degeneration (AMD). It is a human vascular endothelial growth factor (VEGF) inhibitor. Common side effects include blurred vision, cataracts and eye hemorrhage.
The U.S. Food and Drug Administration approved Beovu in 2019 to treat wet AMD, a condition where abnormal blood vessels develop in the eye, causing fluid to leak into the macula. This leads to blurred vision and blind spots in central vision.
Beovu treats wet AMD but doesn’t cure it.
Doctors inject Beovu into the eye. Beovu works by blocking vascular endothelial growth factor (VEGF), a protein responsible for producing new blood vessels. Beovu helps slow the growth of abnormal blood vessels that cause wet AMD symptoms.
Researchers studied Beovu in two clinical studies of 730 people with wet AMD. After treatment, people were able to read an additional seven letters on an eye chart, according to study results on Beovu’s website. Thirty percent of people gained 15 letters. Ninety-three percent of those people maintained improved vision after one year.
Medicare covers anti-VEGF injections, including Beovu.
In addition to common side effects, Beovu has a handful of serious side effects that can lead to blindness.
Dosage and Instructions
Medical providers are the only ones who can administer Beovu, and they will decide what dosing schedule works best for each patient.
Beovu’s recommended dosage starts with 6 mg a month for the first three months. After those initial treatments, patients receive Beovu once every two to three months.
Providers use a 30-gauge x ½ inch needle to inject the medication into the eye. Before the injection, patients receive anesthesia and disinfectants to the eye.
The doctor will check the patient for signs of retinal detachment, an emergency in which part of the eye pulls away from the supportive tissue. They will also check for inflammation of the eye’s interior called endophthalmitis.
Patients should tell their doctor if they have symptoms including eye pain, redness, blurring of vision and photophobia.
Eye Injection Side Effects
The most common Beovu eye injection side effects from clinical trials include blurred vision, cataracts, eye hemorrhage and blood vessel inflammation in the back of the eye.
Researchers tested Beovu’s safety in 1088 patients in two controlled phase three studies. Out of those patients, 730 patients received the Beovu and 729 received another drug called Eylea (aflibercept).
Common side effects occurred in one to 10 percent of study participants who took Beovu.
- Blurred vision – 10 percent
- Cataract – 7 percent
- Conjunctival hemorrhage – 6 percent
- Vitreous floaters (gray specks or strings that drift across the eyes) – 5 percent
- Eye pain – 5 percent
- Intraocular inflammation – 4 percent
- Intraocular pressure increased – 4 percent
- Retinal hemorrhage (bleeding in the eye) – 4 percent
- Conjunctivitis – 3 percent
- Retinal pigment epithelial tear – 3 percent
- Corneal abrasion – 2 percent
- Hypersensitivity – 2 percent
- Punctate keratitis (death of cells in the cornea) – 1 percent
- Retinal tear – 1 percent
- Endophthalmitis – 1 percent
- Blindness – 1 percent
- Retinal artery occlusion – 1 percent
- Retinal detachment – 1 percent
- Conjunctival hyperemia (sign of inflammation) – 1 percent
- Lacrimation increased (watering eye) – 1 percent
- Abnormal sensation in eye – 1 percent
- Detachment of retinal pigment epithelium, a part of the eye that protect the outer retina – 1 percent
Serious Side Effects
Beovu’s prescription insert includes warnings for several serious side effects including endophthalmitis, retinal detachment, retinal vasculitis, retinal vascular occlusion, increase in intraocular pressure and thromboembolic events.
The risk of these problems occurs in the days following the injection. Patients should report all symptoms to their doctor immediately. These include redness, light sensitivity, eye pain or changes in vision.
Endophthalmitis and Retinal Detachment
Beovu and other eye injections have been linked with endophthalmitis and retinal detachment. Endophthalmitis is inflammation of the inner eye. Retinal detachment is a serious, emergency condition that occurs when the retina detaches from the back of the eye.
Retinal Vasculitis and/or Retinal Vascular Occlusion
Retinal vasculitis and/or retinal vascular occlusion have been reported in people who used brolucizumab. Retinal vasculitis is inflammation of the retinal artery.
Retinal vascular occlusion occurs when a blood clot blocks the veins in the eyes. It can lead to sudden blindness and vision loss. Report any change in vision to medical providers right away.
Novartis added the vasculitis and occlusion warnings to its labels in June 2020. Some lawyers are investigating Beovu lawsuits on behalf of people who suffered retinal vasculitis, retinal artery occlusion, eye inflammation or other vision problems.
Increase in Intraocular Pressure
Some people suffered an acute increase in intraocular pressure (IOP) within 30 minutes of Beovu and other eye injections. Some of these increases were sustained. IOP happens when there is a fluid imbalance in the eye. It can damage the optic nerve and cause glaucoma. Doctors will monitor patients for this side effect because there are no outward symptoms.
Researchers found a low rate of arterial thromboembolic events (ATEs) in Beovu clinical trial participants. These events include nonfatal stroke, nonfatal myocardial infarction or vascular death. In clinical trials 33 of 730 (about 4 percent) people suffered an ATE, according to the prescribing information.
Drug Interactions and Precautions
There haven’t been enough studies on Beovu to determine any drug interactions.
Scientists haven’t studied if the drug can cause cancer. The drug’s safety and efficacy haven’t been tested in pediatric patients, but there was no significant difference in the drug’s safety or efficacy based on an adult’s age.
Pregnancy and Birth Defects
Beovu hasn’t been adequately studied in pregnant women, but studies in animals showed the drug could harm a fetus. Based on studies of its anti-VEGF properties, it may negatively affect fertility in women and men.
Women shouldn’t breastfeed for at least one month after the last dose of Beovu.
Who Shouldn’t Use Beovu
Beovu isn’t safe for everyone. People who are allergic to any ingredients in Beovu, people with eye infections and people with eye inflammation shouldn’t use the drug.
- About all medications, supplements or vitamins you are taking
- If you are pregnant or plan to become pregnant
- If you are breast-feeding
- If you have any active eye infections
- If you have any health conditions
Please seek the advice of a medical professional before making health care decisions.