Abstract
Purpose :
To evaluate the effectiveness of intravitreal faricimab in alleviating disease burden in a US veteran population.
Methods :
Chart review was performed for all patients with at least one intravitreal faricimab injection recorded in the US Veterans Health Administration’s Corporate Data Warehouse in 2022 (n=572 eyes of 451 patients at 33 sites). Exclusion criteria included intervening intravitreal injection of a different medication, cataract extraction in the study time frame, or incomplete chart notes at key follow-up visits. The primary study outcome was control of disease activity in the subset of eyes that received ≥3 doses of aflibercept followed by ≥3 doses of faricimab. Secondary outcomes included treatment interval length and adverse events. Differences were assessed using Fisher’s exact and paired t-tests.
Results :
Mean±SD age was 74.2±8.9 years. Most patients were male (97%) and white (80%). Treatment indications were exudative age-related macular degeneration (AMD) in 314 eyes (55%) and diabetic macular edema (DME) in 219 eyes (38%). Adverse events occurred in 5 eyes (1%).
Of the 212 eyes (167 patients) in the aflibercept-faricimab comparison subcohort, reasons for the medication switch included inadequate disease control in 88 eyes (42%) and desire to extend treatment interval in 65 eyes (31%). Inactive disease was documented in 22 eyes (10%) at the time of first faricimab injection. Following the first faricimab injection there were significantly more eyes with inactive disease in the setting of AMD (p<0.001) but not DME (p=1) (Figure 1), although there were significantly more DME eyes with disease improvement (p=0.004) (Figure 2). Short-term treatment interval duration was stable: mean±SD interval between the last aflibercept dose and the first faricimab dose was similar to the interval between the third and fourth faricimab doses for the comparison subcohort (46.5±26.8 days, 44.3±22.0 days, p = 0.29) and the subset with desired interval extension (44.2±20.4 days, 44.1±18.4 days, p = 0.97).
Conclusions :
Faricimab may facilitate disease control in exudative AMD recalcitrant to aflibercept. Ongoing follow-up of this study cohort will assess the feasibility of long-term treatment interval extension with faricimab.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.