Clinical Outcomes of Faricimab in Patients with Previously Treated Neovascular Age-Related Macular Degeneration

Abstract

PurposeTo assess the anatomic and functional outcomes in eyes with neovascular age-related macular degeneration (nAMD) previously treated with anti-vascular endothelial growth factor therapy in response to intravitreal faricimab. DesignRetrospective, interventional consecutive case series. Subjects, Participants, and/or ControlsPatients with previously treated nAMD who received at least 4 consecutive injections of faricimab were included. The study period was from March through November 2022. Methods, Intervention, or TestingClinical and imaging data were extracted from the electronic medical record. Central foveal thickness (CFT), maximum fibrovascular pigment epithelial detachment (fvPED) height, and Snellen VA were obtained. Generalized estimated equations were used to analyze the change in CFT, maximum fvPED height, and logMAR VA. Main Outcome MeasuresChange in CFT, maximum fvPED height, and Snellen VA prior to faricimab and after at least four faricimab intravitreal injections. ResultDuring the study period, 218 eyes of 191 patients met inclusion criteria. Mean (range) age was 79.9 years (70.6-89.2). The mean number of intravitreal anti-VEGF injections received prior to faricimab was 34.2 (6.4-62). The following results were found after ≥4 faricimab injections. Mean logarithm of minimum of angle of resolution (logMAR) VA prior to switching to faricimab was 0.58 (∼Snellen VA 20/76, range: 20/22 – 20/264) and was 0.55 (∼Snellen VA 20/71, range: range: 20/21-20/235, p = 0.195) after switching. Mean maximum fvPED height was 195.0 μm (50.2-339.8) prior to switching to faricimab and improved to 165.0μm (33.6 – 296.4, p<0.0001) after switching. Mean CFT was 354.8 μm (184.7- 524.9) prior to switching to faricimab and improved to 306.6 μm (range: 144.4-468.8, p<0.0001) after switching. The proportion of eyes with intraretinal fluid (IRF) was 36.7% (80/218 eyes) prior to switch, and decreased to 24.8% (54/218 eyes, p<0.0001) after switch. The proportion of eyes with subretinal fluid (SRF) was 53.2% (116/218 eyes) prior to switch and decreased to 26.6% (58/218 eyes, p<0.0001) after switch. ConclusionsIntravitreal faricimab may improve anatomic outcomes in patients with previously treated nAMD, while maintaining visual acuity in the short-term.