BLOG: How retina specialists have used faricimab for wet AMD in the real world
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Key takeaways:
- Researchers used the IRIS Registry to investigate real-world use of faricimab.
- Approximately 12,100 eyes were identified as receiving faricimab for wet age-related macular degeneration.
When faricimab became the first bispecific antibody approved by the FDA for use in ophthalmology, retina specialists who treat wet age-related macular degeneration and diabetic macular edema were presented with a new treatment option.
But how did retina specialists in the real world respond? Anecdotally, we know that some doctors enthusiastically embraced Vabysmo (faricimab-svoa, Genentech), seeing it as a treatment option that could extend duration of therapy via a dual mechanism of action. Others were more cautious, waiting to see how patients outside of tightly controlled clinical trials responded to the new agent before offering it to their patients.
But anecdotes insufficiently describe large-scale patterns. To thoroughly characterize faricimab’s uptake and patients’ response to this new therapy, my colleagues and I turned to an in-depth analysis of electronic health record data housed in the American Academy of Ophthalmology IRIS Registry. This study is the FARETINA-AMD study, which was presented at this year’s Association for Research in Vision and Ophthalmology annual meeting.
Study findings
In FARETINA-AMD, my colleagues and I searched the IRIS Registry for patients with wet AMD who received at least one faricimab injection in the initial 7 months following the drug’s approval. Only patients who had at least 12 months of EHR data before they received their first dose of faricimab were considered, and those who had at least four faricimab injections were further analyzed to determine injection interval patterns and best documented visual acuity (BDVA) trends.
In all, 12,100 eyes of 10,500 patients were identified as receiving faricimab for wet AMD. (Note: All figures in this blog post are approximated.) Only 1,600 eyes (13%) were treatment naive, with more than 10,000 (87%) having already undergone treatment with another anti-VEGF agent. Patients received a mean 2.6 injections during a mean follow-up period of 55 days.
We identified 2,900 eyes that received at least four faricimab doses. Among those eyes, the following dynamics were observed:
- Similar percentages of treatment-naive eyes (26%) and previously treated eyes (23%) were dosed with at least four injections of faricimab.
- After four injections, treatment-naive eyes gained mean BDVA 1.6 letters compared with mean BDVA 0.5 letters gained among eyes that had been previously treated.
We look forward to learning more about the dynamics of real-world faricimab treatment for wet AMD and expect to have larger patient populations to examine during future check-ins. Several questions remain (Did any baseline characteristics predict disease response? Are previously treated eyes that required monthly dosing able to extend their treatment interval upon switching to faricimab?), and a well-curated, real-world database such as the IRIS Registry will be key to helping unlock the answers.
Reference:
- Borkar D, et al. Early treatment patterns and clinical response in patients with neovascular age-related macular degeneration initiating faricimab: an IRIS Registry analysis. Presented at: Association for Research in Vision and Ophthalmology annual meeting; April 23-27, 2023; New Orleans. https://www.veranahealth.com/app/uploads/2023/04/Verana_Health_ARVO_2023_FAR_Durga_Borkar_FINAL_042823.pdf.
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