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TOPLINE:

Faricimab is as effective as aflibercept in improving visual acuity for patients with diabetic macular edema who have baseline vision of 20/50 or worse. Faricimab also provides superior reductions in retinal thickness and achieves these outcomes with fewer injections.

METHODOLOGY:

• This post hoc analysis of two trials compared faricimab and aflibercept in patients with diabetic macular edema who had baseline vision of 20/50 or worse.
• Researchers randomly assigned patients (1:1:1) to receive either 6 mg faricimab every 8 weeks, faricimab using a personalized treat-and-extend regimen, or 2 mg aflibercept every 8 weeks.
• The primary outcomes were changes in best-corrected visual acuity and central subfield thickness (CST) from baseline over 2 years.

TAKEAWAY:

• At 2 years, both treatment regimens of faricimab were associated with improvements in visual acuity compared with the treatment regimen of aflibercept (P ≥ .08 for all).
• Both treatment groups of faricimab showed a greater reduction in CST than the treatment group of aflibercept at 1 and 2 years (P ≤ .01 for all comparisons).
• Patients treated with faricimab reached a CST < 325 µm and absence of intraretinal fluid more quickly and with fewer injections than those treated with aflibercept.

IN PRACTICE:

These findings show that in patients with diabetic macular edema, "VEGF [vascular endothelial growth factor]/angiopoietin-2 inhibition with faricimab achieved comparable changes in visual acuity and greater anatomical improvement with fewer injections compared with anti-VEGF therapy with aflibercept over 2 years of treatment," the authors wrote.

SOURCE:

The study was led by Marco Zarbin, MD, PhD, of the Department of Ophthalmology & Visual Science at Rutgers New Jersey Medical School, in Newark, New Jersey, and was published online on June 8, 2024, in Ophthalmology.

LIMITATIONS:

These findings are based on post hoc analyses, which might have introduced bias. Most patients were White, which limited the generalizability of findings to other racial or ethnic groups.

DISCLOSURES:

This study was supported by Genentech, Inc., a subsidiary of the Roche Group. Seven authors were employees of Genentech. Other authors disclosed being consultants and speakers and having various ties with sources including Genentech.