Real-World Efficacy of Faricimab in Treatment Resistant Neovascular Age-Related Macular Degeneration: A 12 Month Cohort Study

Background: Faricimab, the first bispecific anti-VEGF agent, has shown efficacy in treating neovascular Age-Related Macular Degeneration (AMD). However, existing studies often exclude anti-VEGF resistant patients, involve small sample sizes, or focus on short-term outcomes. This study aims to evaluate the real-world outcomes of faricimab in treatment-resistant neovascular AMD patients over a 12-month period. Methods: This is a single-centre, retrospective cohort study conducted using clinical and imaging data from Salisbury district hospital, UK, between October 2022 to November 2023. Results: A total of 191 eyes from 156 patients, with a mean age of 81.4 years and a history of 19.9 previous anti-VEGF injections per eye, were analysed. The baseline mean Best-Corrected Visual Acuity (BCVA) was 0.40 ± 0.26, and the mean Central Subfield Thickness (CST) was 283.5 μm ± 67.3 μm. After a mean follow-up of 8 months, patients received a mean of 6.49 ± 1.99 faricimab injections. A significant reduction in CST was observed, with a decrease of 283.5 ± 67.3 μm at baseline to 268.86 ± 75.06 μm at the 12-month interval, indicating anatomical improvement. Notably, the majority of patients were successfully extended to an 8-week injection interval, with a mean interval of 7.8 weeks. Conclusions: Switching to faricimab in treatment-resistant neovascular AMD patients resulted in anatomical improvement in CST and maintenance of BCVA. These findings suggest that faricimab is a safe and effective treatment, with the potential for prolonged injection intervals. Longer-term follow-up is needed to assess the durability of these results. Keywords: Faricimab; Neovascular age-related macular degeneration; anti-VEGF