2-year real-world clinical outcomes on the use of Faricimab in neovascular age-related macular degeneration

Abstract Background Long-term real-world data on the efficacy of Faricimab in nAMD remains scarce. Functional and structural outcomes for both treatment naïve (TN) and previous treatment exposed (TE) patients up to 104 weeks are reported. Methods 107 eyes (37 TN and 70 TE) from 92 patients treated at Bradford Macula Centre were included in this retrospective cohort study. TE patients were grouped according to their pre-switch injection interval; the short interval (4–5 weeks) “SITE” group and the long interval ( ≥ 6 weeks) “LITE” group. Data was extracted on visual acuity (VA), central macular thickness (CMT), presence and type of retinal fluid and injection interval at the following timepoints: baseline, 12weeks, 26 weeks, 52 weeks, 78 weeks and 104 weeks. Results TN patients gained a mean of +5.4 letters by 52 weeks reducing to +4.5 by 104 weeks. This coincided with a reduction in CMT and decrease in all types of retinal fluid. TE eyes showed attrition of VA despite a reduction in CMT, and by 104 weeks the “LITE” group had lost significantly more letters than the “SITE” group ( p = 0.003). By 104 weeks the macula was dry in 48.5% of TN eyes, 42.4% of “LITE” eyes and 31.0% of “SITE” eyes. The proportion of patients achieving a ≥12week interval by 104 weeks was 54.5% TN, 32.4% “LITE” and 17.2% “SITE” respectively. Conclusion Faricimab is an effective treatment for naïve eyes with nAMD, where retinal structural and functional improvement can be maintained for 2 years in real-world practice. Treatment experienced eyes show modest improvement in structure and no improvement in vision with Faricimab, and some TE eyes continue to lose vision over 2 years. Longer treatment intervals can be possible, but vigilance for undertreatment is needed. Further studies will help evaluate the long-term impact.