Abstract
Purpose :
Treatment of neovascular age-related macular degeneration (nAMD) has unequivocally improved outcomes and quality of life for affected individuals; however, it adds to a growing service burden. Phase 3 clinical trials showed promising results with intravitreal Faricimab, a new drug with dual inhibition of vascular endothelial growth factor and angiopoietin-2, with the potential of less frequent injections with efficacy maintained. We present outcomes from our clinical practice of Faricimab use in treatment-naïve nAMD.
Methods :
Retrospective data for patients started on Faricimab between September 2022-September 2023 was collected. Standardised treatment protocol with 4 ‘loading’ monthly injections, then at 8 weeks, followed by personalised treatment interval (PTI) with 2 weekly extension ('treat and extend') was followed. We report baseline characteristics, treatment intervals and outcomes. R software was used for statistical analysis.
Results :
One hundred seventy four eyes of 163 patients (56 % females) with a mean age of 80 yrs (SD 7.03) were included. Average baseline best recorded visual acuity (VA) was 56 ETDRS letters (SD 15.2). After 3 injections (n=132 eyes), mean change in VA was +4.3 letters (95% CI 2.3 6.3, P <0.001), while change in central subfield thickness on OCT was -116 µm (95% CI -132.4, -100.13, P <0.001); both remained stable on extension to 8 weeks (visit 5; n = 102 eyes). Eight weeks post-loading, 89% of eyes were deemed inactive, 8% were minimally active, and 3% had active nAMD. At visit 6 (n=67 eyes), 4% were on < 8 weekly treatment, 57% were on 8 weekly and 39% on ≥10 weeks interval. At month 12 of therapy (n=17 eyes), 76% were on ≥10 weekly treatment.
Conclusions :
Improvement in visual acuity and retinal thickness was statistically and clinically significant following four loading injections with 97% of treated eyes having stable nAMD. At first PTI, 96% of eyes were on ≥8 week interval. At year 1, ≥10 weekly interval was maintained in 76%. Our limitation is that 1 year data was not available for all patients included in the study, however, outcomes from this real-world setting are so far comparable to TENAYA and LUCERNE in which 80% of patients were on ≥12 weekly treatment at 48 weeks.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.