Good outcomes seen 9 months after switching to faricimab for wet AMD treatment
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Eyes with neovascular age-related macular degeneration that switched to faricimab generally had lower rates of lesion activity, longer treatment intervals and stable visual acuity.
A database observational study, presented by Adrian Hunt, MBBS, MBiomedE, FRANZCO, at the American Society of Retina Specialists annual meeting, used data from the Fight Retinal Blindness! Registry based in Sydney to determine the outcomes of switching to faricimab from existing agents between January 2023 and August 2023 in a real-world setting for patients with neovascular AMD.
Of the 297 eyes included in the study (mean age at switch, 82 years), 9-month follow-up was available for 278 eyes (94%). Most switched to faricimab, a bispecific antibody targeting VEGF-A and Ang-2, from aflibercept (92.3%), followed by ranibizumab (7.4%) and bevacizumab (0.3%). Primary outcomes were choroidal neovascularization activity, categorized as inactive, subretinal fluid only or high activity with intraretinal fluid or hemorrhage. Secondary outcomes included injection interval and visual acuity.
At the switch, 34% of eyes were inactive, 33% had subretinal fluid only and 33% had intraretinal fluid or hemorrhage. At 9 months, 55% of eyes were inactive, 25% had subretinal fluid only and 20% had intraretinal fluid or hemorrhage. The difference was significant (P < .001). The mean treatment interval extended significantly from 6.6 weeks to 9 weeks (P < .001). Visual acuity slightly decreased from 71.4 letters to 69.8 letters, driven by inactive eyes that lost 2.4 letters whereas the subretinal fluid and intraretinal fluid or hemorrhage eyes did not have a significant reduction in vision.
There were no reports of intraocular inflammation, vasculitis or occlusive retinitis after 1,605 injections; there was one case of infectious endophthalmitis. Eleven eyes (4%) switched from faricimab back to aflibercept.
According to Hunt, reactivation rates of eyes inactive at the switch were low, “considering that treatment intervals were extended significantly.”
“In future research, treatment-naive eyes may come closer to replicating the efficacy and durability of faricimab that was demonstrated in the trials,” he said.
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Hunt A, et al. Outcomes of switching to faricimab for nAMD in ex-US routine clinical practice: Data from the Fight Retinal Blindness! project. Presented at: American Society of Retina Specialists annual meeting; July 17-20, 2024; Stockholm.
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