Short-term outcomes of switching from intravitreal brolucizumab to faricimab for neovascular age-related macular degeneration: A single-center retrospective study

Abstract

Purpose : To investigate factors related to changes in central subfield macular thickness (CSMT) when switching from intravitreal brolucizumab (IVBr) to intravitreal faricimab (IVF) for neovascular age-related macular degeneration (nAMD).

Methods : This single-center retrospective study reviewed 82 eyes of 74 patients with nAMD who had received IVBr injections as prior anti-vascular endothelial growth factor therapy before their initial IVF injection at Jichi Medical University from May to September 2022. Of these, 51 eyes of 49 patients were followed-up after the initial IVF injection for a post-switch injection interval that was the same as the pre-switch injection interval. We evaluated differences in CSMT and best-corrected visual acuity (BCVA) between baseline at the initial IVF injection and at the end of the post-switch injection interval. We also conducted multivariate regression analysis to examine the associations of the following factors with changes in CSMT: baseline central choroidal thickness (CCT), post-switch CCT, baseline BCVA, post-switch BCVA, disease type (macular neovascularization [MNV] types 1, 2, and 3, and polypoidal choroidal vasculopathy), axial length, number of prior any anti-VEGF agents’ injections, and disease duration.

Results : Mean age was 75.9 ± 8.9 years, and 34 of the 49 patients were male. At baseline, CSMT, LogMAR BCVA, and CCT were 244 ± 77.7 µm, 0.36 ± 0.36, and 181 ± 81.3 µm, respectively. After switching, these were 244 ± 93.7 µm, 0.37 ± 0.38, and 174 ± 78.7 µm. Disease type was MNV1 in 13 eyes, MNV2 in 5, MNV3 in 2, and PCV in 31. A significant change was seen in CCT but not CSMT and BCVA (P = 0.006, 0.93, and 0.56, respectively; paired t-test). Multivariate regression analysis showed no factors significantly associated with changes in CSMT and BCVA but CCT. Thicker pre-switch CCT was significantly associated with change of CCT (P= 0.04).

Conclusions : These short-term outcomes suggest that CSMT and BCVA do not change significantly after switching from IVBr to IVF but CCT might decrease.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.