Faricimab in Neovascular AMD

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 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 and 256.16 µm respectively, with a mean 36-day previous treatment interval. The median number of other previous anti-VEGF intravitreal injections was 8. The mean baseline BVCA and CRT values of the 3 naïve patients were 0.33 and 874.67 µm, respectively. At one month follow-up, mean BCVA improvement was 0.32 and mean CRT reduction was 338.44 µm. A complete resolution of SRF and IRF was observed in 75% and 33.33%, respectively. Drusenoid PED morphology changes were observed in all patients. 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.

Analysis of quantitative OCT and SS-OCTA metrics three months after initiation of intravitreal faricimab for treatment-recalcitrant neovascular AMD

“…However, up to 30% of patients fail to respond to traditional anti-VEGF agents, and such recalcitrant patients may experience persistent subretinal or intraretinal uid despite anti-VEGF treatment. 3,4 Faricimab (Vabysmo ®; Roche/Genentech; Basel, Switzerland), a recently approved monoclonal antibody, has shown promise as a tool to control macular neovascularization (MNV) and to extend treatment intervals in patients with nAMD. Faricimab is a bispeci c antibody blocking both angiopoietin 2 (Ang-2) and VEGF angiogenesis pathways.…”