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Intravitreal faricimab for neovascular age-related macular degeneration previously treated with traditional anti-VEGF compounds: a real-world prospective study

  • Retinal Disorders
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Abstract

Background/aims

To evaluate the efficacy, safety and durability of intravitreal faricimab in patients with neovascular age-related macular degeneration (nAMD) with unsatisfactory response to traditional anti-vascular endothelial growth factor (anti-VEGF) agents.

Methods

Single-centre, prospective cohort study of all consecutive patients with nAMD who were switched to intravitreal faricimab from intravitreal ranibizumab or aflibercept, due to unsatisfactory treatment response (maximal fluid-free interval ≤ 8 weeks). Intravitreal faricimab was administered with a loading dose of four 4-weekly injections, followed by an 8-week extension. A treat and extend (T&E) regime was adopted thereafter. Primary outcome was the difference between the maximal fluid-free interval achieved with faricimab, and the one achieved before the switch. Morpho-functional outcomes were also assessed. Secondary outcome was accordance with clinical management when applying faricimab pivotal trial criteria versus our real-world T&E protocol, measured as a proportion.

Results

Twenty-six eyes of 26 patients with a median age of 82 years (range 77–85) were included. Patients were followed for 30.2 weeks (range 26.3–33.1). Maximal fluid-free interval after switch to faricimab (Mdn = 6.0 weeks; IQR = 4–8) was longer than the maximum interval before the switch (Mdn = 4.0 weeks; IQR = 4–4), p < 0.001. Comparing real-world T&E protocol with pivotal trial criteria, 8 (30.8%) eyes received the same clinical management while 18 (69.2%) eyes were kept at a shorter interval when following our T&E protocol. No serious adverse events were recorded.

Conclusions

Faricimab appears to increase the fluid-free interval and allow extension of dosing interval in patients with nAMD poorly responsive to traditional anti-VEGF drugs.

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Authors and Affiliations

  1. Department of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland

    Gabriela Grimaldi, Giuseppe Cancian, Angelica Rizzato, Alex Casanova, Kathrin Perruchoud-Ader, Michele Clerici, Andrea Consigli & Moreno Menghini

Authors
  1. Gabriela Grimaldi
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  2. Giuseppe Cancian
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  3. Angelica Rizzato
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  4. Alex Casanova
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  5. Kathrin Perruchoud-Ader
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  6. Michele Clerici
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  7. Andrea Consigli
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  8. Moreno Menghini
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Corresponding author

Correspondence to Gabriela Grimaldi.

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Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the local ethics committee of Canton Ticino (2023–00653 CE 4340) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

G. Grimaldi provided consulting and/or speaker services for Apellis, Bayer and Roche. M. Menghini provided consulting and/or speaker services for Bayer, Roche, Novartis, Apellis and AbbVie, and is CMO and holds equity of Endogena Inc. All authors received an unrestricted research grant from Bayer AG Switzerland.

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Grimaldi, G., Cancian, G., Rizzato, A. et al. Intravitreal faricimab for neovascular age-related macular degeneration previously treated with traditional anti-VEGF compounds: a real-world prospective study. Graefes Arch Clin Exp Ophthalmol 262, 1151–1159 (2024). https://doi.org/10.1007/s00417-023-06319-3

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  • DOI: https://doi.org/10.1007/s00417-023-06319-3

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