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Faricimab in neovascular AMD: first report of real-world outcomes in an independent retina clinic

Eye volume 37, pages 3282–3289 (2023)Cite this article

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Abstract

Purpose

Assess short-term real-world outcomes in neovascular aged-related macular degeneration (nAMD) treated with novel faricimab.

Methods

Retrospective case series of nine patients with nAMD (11 eyes) treated with faricimab between May and November 2022. Treatment-naïve patients and non-naïve patients underwent logMAR best corrected visual acuity (BCVA), optical coherence tomography (OCT) DRI OCT-1 Triton (Topcon Corp, Tokyo, Japan), ultra-widefield (UWF) and fundus autofluorescence (FAF) (California Optomap, Optos plc, Dunfermline, Scotland, UK). Previous treatment intervals, number of intravitreal injections, sub/intra retinal fluid (SRF/IRF), central retinal thickness (CRT) and presence/changes in pigment epithelial detachments (PEDs) were recorded.

Results

Mean baseline BCVA and CRT values of patients who switched from other agents were 0.612 ± 0.75 logMAR and 256.16 ± 12.98 µm respectively, with a mean 36-day previous treatment interval. The median number of other previous anti-VEGF intravitreal injections was 8. Mean BCVA at one month significantly improved to 0.387 ± 0.54 logMAR, as well as CRT values which decreased to 245.43 ± 15.34 µm. In the 3 naïve patients, mean baseline BVCA and CRT values were 0.33 ± 0.29 and 874.67 ± 510.86 µm, respectively. At one month follow-up, mean BCVA improved to 0.30 ± 0.29 logMAR and mean CRT was 536.04 ± 36.15 µm. Overall, a significant improvement in BCVA of 0.21 ± 41 logMAR and 238.44 ± 114.9 µm was achieved at one month after the first faricimab intravitreal injection. In addition, a complete resolution of SRF was observed in 6 out of 8 eyes (75%) and of IRF in 2 out of 3 eyes (66.67%), respectively. Drusenoid PED morphology changes were observed in all patients and no drug-related adverse events were observed.

Conclusion

Real-world outcomes showed improvement in BCVA and anatomic parameters at an early timepoint, demonstrating the efficacy and durability of faricimab in nAMD patients. Larger numbers of patients and longer follow-up are needed to determine whether the loading dose is required in all, what percentage of patients experience an improvement, and whether improvement it is maintained.

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Fig. 1: Resolution of SRF and PED flattening after the initial intravitreal injection of faricimab.
Fig. 2: Varying responses in different eyes to faricimab in the same patient.
Fig. 3: Resolution of multiple PEDs after the first faricimab intravitreal injection.
Fig. 4: Efficacy of faricimab in the resolution of subretinal and subRPE haemorrhages.

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Authors and Affiliations

  1. The Retina Clinic London, 140 Harley Street, London, W1G 7LB, UK

    Paulo Eduardo Stanga, Francisco Javier Valentín-Bravo, Sebastian Eduardo Francis Stanga, Ursula Inge Reinstein, Salvador Pastor-Idoate & Susan M. Downes

  2. UCL Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, UK

    Paulo Eduardo Stanga

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Stanga, P.E., Valentín-Bravo, F.J., Stanga, S.E.F. et al. Faricimab in neovascular AMD: first report of real-world outcomes in an independent retina clinic. Eye 37, 3282–3289 (2023). https://doi.org/10.1038/s41433-023-02505-z

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