Real-world clinical and anatomical outcomes in patients with neovascular age-related macular degeneration (nAMD) treated with faricimab: The FARETINA-AMD study

Abstract

Purpose : Anti-vascular endothelial growth factor (VEGF) intravitreal agents for nAMD require frequent injections to mitigate vision loss. Faricimab is the only bispecific antibody for intraocular use that independently binds and neutralizes both angiopoietin-2 and VEGF-A. This study describes the largest real-world evaluation of utilization and clinical response of patients diagnosed with nAMD initiating faricimab.

Methods : FARETINA-AMD is an ongoing, retrospective study using electronic health records (EHR) data derived from US ophthalmology clinics contributing to the American Academy of Ophthalmology IRIS^® Registry (Intelligent Research in Sight). Data analyzed identified patients diagnosed with nAMD who initiated faricimab February 2022–June 2023. Patients with ≥12 months of EHR data prior to faricimab initiation, known laterality, ≥6 months of follow-up, and ≥2 best-documented visual acuity (BDVA) measures were included.

Results : 22,913 patients (27,766 eyes) were treated with faricimab for nAMD, with a mean of 6.8 (standard deviation [SD] 2.7) faricimab injections over a mean (SD) of 313.2 (90.1) days of follow-up. 50% of eyes had 20/40 or better BDVA at faricimab initiation. 1982 (7.2%) eyes were anti-VEGF treatment naive. Mean injection frequency of anti-VEGFs in the prior 12 months was 7.1 (SD 2.8) injections with a mean interval length of 44.2 (SD 22.1) days. 65.9% of previously treated eyes were treated with aflibercept.
Mean change in BDVA from baseline after 4 injections was +2.9 (SD 15.5) letters in treatment-naive eyes and +0.1 (SD 11.1) letters in previously treated eyes. Among eyes with central subfield thickness (CST) captured (n = 4616), mean (SD) CST declined after 3 months by –46.1 (32.6) µm in treatment-naive eyes and –21.8 (15.4) µm in previously treated eyes (nominal p<0.01). 7803 (28.1%) of eyes had ≥12 months of follow-up, with 63.8% of these eyes extending their faricimab injection interval (>6 weeks interval) within 3 initial injections.

Conclusions : Over 27,000 eyes were treated with faricimab for nAMD in the US through June 2023. Vision stability was observed, along with CST improvement. Faricimab treatment intervals were extended within 3 initial doses in most patient eyes. Extensions seen in interval dosing may correlate to early anatomical responses to faricimab in nAMD patients.

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