TOPLINE

In patients with neovascular age-related macular degeneration (nAMD) who did not respond to multiple anti-vascular endothelial growth factor (anti-VEGF) therapies, switching to faricimab kept vision stable and improved retinal anatomy by reducing retinal thickness and resolving or stabilizing fluid buildup. It also reduced treatment burden by stretching the gap between injections from a median of 4-8 weeks.

METHODOLOGY

• Researchers conducted a real-world study across five Portuguese hospitals, analyzing 46 eyes from 40 patients with nAMD (median age, 81.5 years; 57.5% men). All had a poor response or contraindications to three standard anti-VEGF drugs (ranibizumab, aflibercept, and brolucizumab). Patients were then switched to faricimab and followed for at least 6 months.
• Spectral‑domain optical coherence tomography showed persistent, worsening, or recurring fluid within or beneath the retina in these patients despite previous treatment.
• At baseline, patients had a long-standing disease (median duration, 5 years), a high treatment burden (median total number of prior anti-VEGF injections, 32), and short dosing intervals (median, 4 weeks) before switching to faricimab.
• Functional outcomes included changes in vision assessed using best-corrected visual acuity; anatomic outcomes included shifts in central subfield thickness (total retinal thickness) and any changes in the buildup of fluid within or beneath the retina on optical coherence tomography.
• Treatment burden was captured by extension of treatment intervals; most eyes (73.9%) were managed using a treat-and-extend approach rather than a fixed dosing schedule.

TAKEAWAY

• Best-corrected visual acuity remained stable after switching to faricimab.
• Retinal thickness decreased following the switch, with median values declining from 314 μm to 278 μm after switching to faricimab, with a median change of -12 μm.
• Fluid beneath the retina completely cleared in nearly half of eyes (47.8%), partially decreased in 8.7%, remained stable in 8.7%, and was persistently absent in 30.4%; only 4.4% of eyes worsened, and no new cases occurred.
• Retina fluid buildup fully cleared in 6.5% of eyes, partially decreased in 10.9%, stayed stable in 19.6%, worsened in 2.2%, newly appeared in 2.2%, and was persistently absent in 58.7%.
• Faricimab was started at a median of 4 weeks after the last injection of previous anti-VEGF treatment, but by the last visit that gap had stretched to a median of 8 weeks. The proportion of eyes dosed every 7-9 weeks rose from 13.0% to 30.4%, and those reaching 10-12 weeks climbed from none at baseline to 21.7%.

IN PRACTICE

“Earlier use of dual Ang-2 [angiopoietin-2]/VEGF inhibition may be of interest and could potentially be associated with improved clinical outcomes. Such an approach may have possible implications for reducing treatment burden and supporting healthcare system capacity,” the researchers reported.

SOURCE

The study was led by Filipe Mira, of Unidade Local de Saúde do Médio Tejo in Tomar, Portugal. It was published online on July 14 in Ophthalmology and Therapy.

LIMITATIONS

The absence of a control group may have limited interpretability of the findings. The study ran across several centers, so differences in imaging and vision testing could have influenced the results.

DISCLOSURES

The research was supported by Roche Farmaceutica Química Lda., Portugal. Several authors disclosed financial ties — including having employment, participating in advisory boards, and receiving consulting fees and travel grants — with Roche and other pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.