Abstract
Purpose :
Neovascular age related macular degeneration (nvAMD) is a leading cause of severe vision loss in adults over 50. Faricimab-svoa (Vabysmo) is the latest FDA-approved medicine for nvAMD, achieving potent vascular endothelial growth factor (VEGF) inhibition by antagonizing both VEGF and angiopoietin-2 (Ang-2) receptors. The purpose of our study is to evaluate clinical outcomes of Vabysmo in the treatment of nvAMD.
Methods :
This was a retrospective case series of patients who initiated intravitreal Vabysmo injections for refractory nvAMD between March - June 2022 and subsequently received at least four injections. Inclusion criteria were patients with nvAMD, previously receiving intravitreal treatment of bevacizumab, aflibercept or brolucizumab and not having any other treatment in the study eye after initiating Vabysmo. Outcome measures included visual acuity (VA), foveal thickness by optical coherence tomography (OCT), and treatment interval.
Results :
29 eyes of 28 patients (15 females) ranging from 55 to 93 years, were included in the study. 58.6% of studied eyes improved VA, with an average gain of 6.1 letters. 72.4% of eyes achieved a net decrease in foveal thickness, for an average decrease of 78.5µm. 24 patients received their first three injections of Vabysmo apart every four weeks as a loading regimen, four patients had extended intervals due to missed follow ups. The mean pre-Vabysmo treatment interval was 5 weeks, 2 days, and the mean treatment interval with Vabysmo was 6 weeks, 2 days. 62% of subjects were able to achieve an extension in treatment interval compared to their previous therapy. However only 27.6% of these achieved an extension of at least two weeks.
Conclusions :
After switching to Vabysmo, a statistically significant number of treatment-resistant subjects had improvements in visual acuity or reduction in intraretinal or subretinal fluid. While there is a statistical increase in the mean interval for treatment on Vabysmo, only two eyes of a single patient were able to surpass a 10 week interval. This suggests that Vabysmo may yield minor returns in VA, and lowering treatment burden with slightly extended intervals. These results are limited by a small sample size and shorter term followup. More longitudinal analysis is needed to evaluate real world outcomes of Vabysmo for wet AMD.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.