Abstract
Purpose :
Faricimab is a new humanised bispecific immunoglobulin that inhibits angiopoietin-2 and vascular endothelial growth factor A. It is licensed and National Institute of Clinical Excellence (NICE) approved for patients with wet age-related macular degeneration (wAMD) and diabetic macular oedema (DMO) in England. No published data currently exists regarding response to faricimab in eyes with wAMD previously treated with other anti-VEGF agents and there is minimal data in DMO in eyes treated within the preceding 3 months. This retrospective audit investigated the effect of the first two faricimab injections on visual acuity (VA), central retinal thickness (CRT) and macular volumes in patients with wAMD and DMO who had required 4-weekly aflibercept prior to commencing faricimab.
Methods :
59 eyes were identified by electronic patient reporting software over the inclusion period. 41 and eighteen eyes were treated for wAMD and DMO respectively. Data including VA, CRT and macular volume was collected retrospectively using electronic patient reporting software in a London based tertiary healthcare setting prior to and following the first two doses of faricimab. Thirty-six and twelve eyes received at least two consecutive IVT of faricimab for wAMD and DMO respectively. Eleven eyes were excluded from analysis due to appointment non-attendances and imaging-system errors. Quantitative analysis was performed using basic statistical software.
Results :
Mean age of patients was 81.8 (SD 7.79) and 62.4 (SD 20.0) years respectively. For wAMD mean changes were +0.01 (SD 0.15) logMAR, -42.6 (SD 58.1) micron CRT and volume -0.50 (SD 0.67) microns cubed and for DMO were -0.05 (SD 0.27) logMAR, -33.25 (SD 48.2) micron CRT and -0.32 (SD 0.33) microns cubed.
Conclusions :
Eyes that have had sustained VEGF inhibition prior to commencing faricimab demonstrate improved macular anatomy following the first two doses. This indicates the significant role of the angiopoetin pathway as a causative factor of macular oedema in these patients. The initial results are reassuring, however the longer-term outcomes in non-treatment naive patients are needed.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.