Initial Real-World Experience with Faricimab in Treatment-Resistant Neovascular Age-Related Macular Degeneration

Ella H Leung, Daniel J Oh, Shannon E Alderson, Joshlynn Bracy, Mia McLeod, Litzi I Perez, Alexander Bottini, David Chin Yee, Krishna Mukkamala Georgia Retina, Atlanta, GA, USACorrespondence: Ella H Leung, 833 Campbell Hill St NW, Suite 300, Marietta, GA, 30060, USA, Tel +1 770-218-1888, Email eleung@garetina.comPurpose: To evaluate the initial efficacy and safety of intravitreal faricimab in eyes previously treated for neovascular age-related macular degeneration (nARMD).Patients and methods: A retrospective review of all patients with nARMD previously treated with anti-vascular endothelial growth factor (anti-VEGF) injections who received at least 3 intravitreal faricimab injections with at least 3 months of follow-up.Results: A total of 190 eyes were included. Patients received a mean of 34.2± 23 anti-VEGF injections over 182.41± 128 weeks prior to switching to faricimab. Patients then received a mean of 6.99± 2.3 faricimab injections with an average 34.88± 8.2 weeks of follow-up. The mean best corrected visual acuities improved from 0.33± 0.32 logMAR &ap;20/43 to 0.27± 0.32 logMAR &ap;20/37 (P=0.0022). The central subfield thickness (CST) improved from 312± 87μm to 287± 71μm (P< 0.0001). At the last clinical visit, 24% had no subretinal fluid or intraretinal fluid on optical coherence tomography. The mean dosing interval between the last two consecutive faricimab injections (7.64± 6.2 weeks) was significantly longer than that for ranibizumab (5.16± 2.0 weeks, P< 0.001) or aflibercept (5.57± 3.6 weeks, P< 0.001). No patients developed idiopathic intraocular inflammation.Conclusion: Intravitreal faricimab was associated with improved vision and CSTs, even in treatment-resistant nARMD eyes. The mean last dosing interval for faricimab was longer than for ranibizumab or aflibercept. No significant adverse events were directly attributed to faricimab during the study.Keywords: faricimab, intravitreal injection, neovascular age-related macular degeneration, intraocular inflammation, anti-vascular endothelial growth factor