TOPLINE

Patients with treatment-resistant neovascular age-related macular degeneration (nAMD) who switched from aflibercept to faricimab maintained visual acuity, showed less retinal fluid and thickness, had longer intervals between treatments, and had few eye complications over 3 years.

METHODOLOGY

• In a retrospective study, researchers reported 3-year outcomes in eyes with treatment‑resistant nAMD after switching from aflibercept to faricimab.
• They included 133 eyes from 107 patients (mean age at baseline, 82.8 years) at a UK eye hospital. The eyes had persistent or recurrent retinal fluid (intraretinal or subretinal or both) despite treatment with aflibercept 2 mg at intervals of 8 weeks or less (mean, 7.6 injections in the prior year).
• After a loading phase of four monthly injections of faricimab, all eyes were treated with a personalized treat-and-extend approach. The mean follow-up duration was 38.8 months.
• Researchers assessed measures such as best‑recorded visual acuity (ETDRS letters), central subfield thickness, the proportion of eyes with resolution of retinal fluids, the duration of intervals between treatments, and eye-related adverse events.

TAKEAWAY

• The mean best-recorded visual acuity remained largely unchanged over 3 years. The mean central subfield thickness decreased from 304.7 µm at baseline to 219.5 µm at year 3 (mean change, -85.2 µm; P < .001).
• The proportion of eyes with complete resolution of both intraretinal and subretinal fluid increased from 10.5% to 55.6% at year 3. The prevalence of subretinal fluid in the eyes decreased from 79.7% to 30.8% (P < .001), and that of intraretinal fluid decreased from 32.3% to 21.1% (P = .022).
• The mean interval between treatments increased from 5.8 weeks before switching to 11.5 weeks at year 3 (P < .001), with 45.9% of the eyes receiving treatment at intervals of at least 12 weeks at final follow-up. 
• Four eyes (3%) experienced eye-related adverse events across 2696 faricimab injections. No endophthalmitis or faricimab-related systemic events occurred.

IN PRACTICE

"[The] findings suggest that switching to faricimab may provide sustained anatomical improvement, treatment-interval extension, and preservation of visual acuity over three years in treatment-resistant nAMD," the researchers reported.

SOURCE

The study was led by Pierluigi Daniele of Bristol Eye Hospital in Bristol, England. It was published online on October 2 as a brief communication in Eye.

LIMITATIONS

The study was retrospective and lacked a comparator. Physicians directed the dosing intervals for each patient.

DISCLOSURES

The study did not receive any funding. Roche, the manufacturer of faricimab, provided funding for open access publication but had no involvement in the research. Two authors reported receiving advisory-board roles, speaker fees, and travel support from companies including Roche. Detailed author disclosures are reported in the original article.

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