Anatomical and visual outcomes of patients with active neovascular age related macular degeneration(nAMD) requiring monthly anti-VEGF treatment following switch to faricimab

Abstract

Purpose : Faricimab has recently been approved in the UK for the treatment of nAMD. We report structural and functional outcomes of patients requiring monthly treatment of intravitreal ranibizumab or aflibercept switched to faricimab

Methods : Retrospective analysis of all nAMD patients on a treat and extend intravitreal ranibizumab or aflibercept regimen who were unable to extend beyond monthly treatment that were switched to faricimab at Moorfields Eye Hospital, UK, between 5/09/2022 to 16/11/2022. Patients’ records were reviewed and data including patient demographics, type and number of injections in total and past 12 months, mean interval of last 3 injections until switch, best corrected visual acuity(BCVA), central subfield thickness(CST), presence of macular fluid at baseline and after the first and second injection were collected. Statistical analysis was performed using SPSS 20.0.0(IBM Corporation, NY)

Results : From a total of 267 eyes who were switched to faricimab, 129 eyes required less than 5 weekly intervals and 95 eyes had completed 2 consecutive monthly injections with data available a month after the second injection. Mean age of the cohort included was 74.1±7.6 years with 89.9% of patients on aflibercept and 10.1% on ranibizumab prior to switch. All patients had completed at least 1 year of treatment prior to switch. Median number of total injections prior to switch was 28 and mean number of injections in past 12months was 9.83±2.29. Mean interval of last 3 injections until switch was 4.17±0.23 weeks (range: 4-4.7weeks). 79.8% of eyes had subretinal and/or intraretinal fluid, 3.9% new macular haemorrhage and 20.2% dry maculae. At 4.27±0.62 weeks following the second faricimab injection, mean BCVA change was +0.52±0.69 ΕTDRS letters, however this difference did not reach statistical significance (p=0.19). Mean CST reduction was 20.19±7.01μm (95%CI=[3.091, 37.296]) (p=0.015) and 60% of maculae were dry. Cochran’s Q test showed statistically significant increase in percentage of dry maculae post 1^st and 2^nd injection(p<0.001). No intraocular inflammation/endophthalmitis were reported

Conclusions : Our results suggest nAMD patients with aggressive disease requiring regular and intensive treatment with anti-VEGF when switched to faricimab, maintained visual acuities and more importantly, improved anatomical outcomes

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