TALON Study Informs on Brolucizumab vs. Aflibercept in nAMD Treatment

The TALON study found that brolucizumab supported longer treat‑and‑extend intervals at Week 64 without loss of visual‑acuity efficacy versus aflibercept. The 64‑week trial used an identical treat‑and‑extend protocol with interval adjustments up to 16 weeks and directly compared the two agents—findings that point to a concrete opportunity to reduce injection frequency and overall treatment burden for patients with nAMD.

Treat‑and‑extend regimens in routine practice tailor visit and injection intervals to disease activity to balance vision maintenance and clinic workload. The ability to extend reliably to q16w matters: it reduces visit frequency, eases scheduling pressure, and can improve adherence and clinic throughput—making care more predictable for patients and teams alike.

At Week 64, 28.4% of patients treated with brolucizumab reached a 16‑week interval without disease activity versus 12.2% with aflibercept. Visual‑acuity change was comparable between arms (mean gains +4.7 letters for brolucizumab vs +4.9 letters for aflibercept), indicating clinically equivalent visual outcomes despite the longer intervals with brolucizumab.

Anatomical outcomes on OCT also favored brolucizumab: mean central subfield thickness fell by −182.9 µm versus −167.5 µm with aflibercept, and fewer brolucizumab‑treated eyes had intra‑ or subretinal fluid at Week 64 (26.6% vs 34.4%). These structural gains provide a plausible mechanistic basis for the longer, stable intervals observed with brolucizumab through stronger suppression of disease activity.

Safety signals differed between arms and clustered early: adverse events of special interest occurred in 22 patients (6.0%) with brolucizumab versus six patients (1.6%) with aflibercept; intraocular inflammation (including retinal vasculitis) was reported in 16 (4.4%) versus five (1.4%); and serious ocular AEs were 11 (~3.0%) versus three (~0.8%). Most AESIs in the brolucizumab arm occurred in the first 32 weeks (20 of 22). The benefit–risk balance therefore pairs extended intervals and stronger anatomical control with an early‑period safety signal that warrants careful monitoring.

Clinically, what’s new: TALON shows higher q16w attainment with brolucizumab while preserving vision—evidence of durable control that can reduce visit frequency and operational load for retina practices. Who’s affected: treatment‑naive nAMD patients eligible for a treat‑and‑extend pathway may gain from fewer injections and visits, but patients should be counselled about early inflammation risk and monitored closely. What changes next: retina teams may consider integrating extended‑interval pathways where brolucizumab is an option, paired with early vigilance protocols for inflammation and clear escalation plans. These data can inform optimization of treat‑and‑extend strategies toward longer, individualized intervals.

Key Takeaways:

• Brolucizumab enabled a greater proportion of patients to reach a 16‑week treat‑and‑extend interval (28.4% vs 12.2%) while maintaining comparable visual gains (+4.7 vs +4.9 letters).
• Anatomical control favored brolucizumab (CSFT −182.9 µm vs −167.5 µm; less retinal fluid at Week 64), supporting its interval durability.
• Safety signals were higher early with brolucizumab (AESIs 6.0% vs 1.6%; IOI 4.4% vs 1.4%), so early‑period monitoring should accompany any extension strategy.