Intraocular Inflammation Associated with Faricimab Therapy: The Moorfields Experience.

Abstract

Purpose : To report real-world evidence of intraocular inflammation (IOI)-associated adverse events (AEs) in patients undergoing faricimab therapy at a major teaching hospital.

Methods : A retrospective review of electronic medical records was conducted for patients receiving faricimab treatment for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) at Moorfields Eye Hospital between September 1st, 2022, and November 1st, 2023. The primary outcome was the incidence of IOI (excluding endophthalmitis). Only patients with a follow-up of at least one month post the data cut-off were included.

Results : 2.631 eyes from 2.092 patients were included and underwent a total of 13.247 injections. Mean population age was 72.3 ±14.2 years. 789 eyes of 659 patients were treatment-naive, while the rest of the eyes had previously received other intravitral treatment. A total of 17 patients (23 eyes) had ≥ 1 adverse event of IOI. Median time from injection to diagnosis was 10 [1-35] days. Estimated incidence of IOI was 0.81% per patient (95% CI 1.30-0.47%) and 0.17% per injection (95% CI 0.11-0.26%]. IOI-related AEs mostly occurred within the first few injections (median 4 injections; range 1–10). All cases presented with anterior uveitis, which was associated with vitritis in 8 eyes (35%). No cases of posterior uveitis e/o retinal vascular occlusion were reported. 16 patients required topical treatment, 1 case needed additional oral steroid treatment, 1 case required glaucoma surgery and 1 case resolved with no treatment. By the end of the study, the majority of patients had recovered their vision to the value before intraocular inflammation.

Conclusions : In this real-world report, faricimab was well tolerated with an incidence of IOI-related AEs lower than registration trials. The AEs were generally mild and had a favourable prognosis. Clinicians should be alert to the minimal risk of inflammation.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Slit-lamp photograph of one eye from the series, taken 21 days after the 6th faricimab injection. The clinical presentation revealed anterior granulomatous uveitis with medium-sized diffuse keratic precipitates.