Effectiveness and Treatment Burden of Faricimab in Neovascular AMD: A Real-World Analysis of Treatment-Naïve and Previously Treated Patients in Poland

Background/Objectives: Faricimab is a bispecific antibody targeting vascular endothelial growth factor A and angiopoietin-2, developed to extend treatment intervals in neovascular age-related macular degeneration (nAMD). Real-world evidence on faricimab within the Polish national drug program remains scarce. This study aimed to assess one-year clinical and treatment outcomes of faricimab for nAMD using real-world data from the Polish Therapeutic Program Monitoring System (SMPT). Methods: In this retrospective, non-randomized registry study, 322 patient-eye records treated with faricimab within the national drug program between January 2024 and April 2025 were analysed. Eligibility required at least 360 days between the first and last injections. Eyes were stratified into treatment-naïve (n = 70) and continuation (switched from another anti-vascular endothelial growth factor (anti-VEGF) agent; n = 252). Results: Median baseline best-corrected visual acuity (BCVA) was 70 [60, 77] letters overall, with no significant difference between subgroups (p = 0.59). At one year, treatment-naïve eyes improved to 75 [66, 79] letters (Δ +5 [0, 10]), whereas continuation eyes were maintained (Δ 0 [−5, 5]; between-group p < 0.001). A clinically meaningful (≥10-letter) gain occurred in 16% of eyes overall, more often in treatment-naïve than continuation eyes (27% vs. 12%; p = 0.004). Central retinal thickness (CRT) decreased significantly in all subgroups, with a greater reduction in treatment-naïve eyes. Intraocular pressure (IOP) remained stable (median Δ 0 mmHg). Patients received a median of 8 [7, 8] injections; injection numbers fell from 5 [4, 5] in the first half-year to 3 [2, 3] in the second, and intervals extended from approximately four to eight weeks. Conclusions: Within the Polish program, one year of faricimab was associated with stable-to-improved vision, anatomical improvement, and progressive extension of injection intervals after the mandated loading phase. Given the observational, single-arm design and the persister-only cohort, findings represent associations rather than comparative effectiveness.