Real-World Data on Faricimab Switching in Treatment-Refractory Neovascular Age-Related Macular Degeneration

• Published in: Life (Basel, Switzerland) Switzerland), 2024-01, Vol.14 (2), p.193
• Main Authors: Ng, Benjamin, Kolli, Hema, Ajith Kumar, Naduviledeth, Azzopardi, Matthew, Logeswaran, Abison, Buensalido, Julius, Mushtaq, Bushra, Chavan, Randhir, Chong, Yu Jeat
• Format: Article
• Language: English
• Subjects: Acuity; Age; Age related diseases; Ang-2; anti-VEGF; Antibodies; Bispecific antibodies; Cancer; Care and treatment; Complications and side effects; Diagnosis; Disease; Eye diseases; faricimab; Injection; Macular degeneration; Morphology; neovascular age-related macular degeneration; Patient outcomes; Patients; Photochemotherapy; Switching; Vascular endothelial growth factor; Visual acuity
• ISSN: 2075-1729; 2075-1729
• DOI: 10.3390/life14020193

Faricimab is a newly approved bispecific antibody for neovascular age-related macular degeneration (nAMD). Our study aims to evaluate clinical outcomes of faricimab switching in patients with treatment-refractory nAMD; determine parameters that predict these outcomes; and obtain patient subjective experience on this new injection. This is a retrospective case review with clinical and imaging data from a tertiary referral unit (Birmingham and Midland Eye Centre, UK), involving patients who were switched to faricimab between 1 January and 1 December 2023. In all, 63 eyes (54 patients) with a mean age of 79.2 ± 7.8 and mean of 41.5 ± 22.4 previous anti-VEGF injections were analysed. With a mean of 4.81 ± 1.16 faricimab injections over 6.98 ± 1.75 months, post-treatment visual acuity was logMAR 0.49 ± 0.36 and central macular thickness (CMT) was 320.3 ± 97.9 µm. After first dose, 39.1% achieved complete dryness and 89.1% had anatomical improvement. Presence of subretinal fluid was a predictor of better functional outcomes ( = 0.001, β = -0.182), while initial CMT predicted better anatomical outcomes ( = 0.001, β = 0.688). Compared to their experiences of previous anti-VEGF injections, 89% of patients reported no more discomfort and 87.0% experienced no more floaters, photopsia, or bubbles post-injection. Faricimab switching has anatomical efficacy but limited functional improvement in treatment-refractory AMD. Patient experiences of faricimab compared to previous injections were overall positive.