Visual and Anatomic Outcomes in nAMD Patients with Subretinal Hemorrhage After Treatment with Faricimab in the TRUCKEE Study

Abstract

Purpose : Faricimab was FDA-approved for nAMD in Jan 2022. Current agents provide benefit to patients but demonstrate declines in visual acuity as treatments continue. Faricimab is the first bispecific agent inhibiting VEGF-A and ANG-2 pathways for the treatment of nAMD and associated subretinal hemorrhage.

Methods : This multi-center prospective study investigates faricimab treatment for nAMD in both treatment-naïve patients and patients switched to faricimab from other anti-VEGF agents. Data collected includes demographics, treatment history, best-corrected visual acuity (BCVA), central subfield thickness (CST), presence of SRH, and presence of subretinal or intraretinal fluid (SRF or IRF). Snellen visual acuity was converted to the Early Treatment Diabetic Retinopathy Study (ETDRS) scoring. Improvements in visual acuity and CST are evaluated as averages. Improvements in SRH and retinal fluid are evaluated as a proportion of patients. Observed and calculated data is reported. Safety is summarized.

Results : 39 eyes across 39 patients were recorded with SRH at time of first faricimab injection. Average age was 80.1 years and 71.8% of patients were female. Following one faricimab injection, 36 eyes saw a -0.56 letter (p=0.75552) mean decrease, a -100.03mm (p=0.0006) mean decrease in CST, and resolution rates for SRH, SRF, and IRF of 33.3%, 50%, and 43.5%, respectively. Following three faricimab injections, 29 eyes demonstrated a +1.66 letter (p=0.30663) mean increase, mean CST decrease of -120.02mm (p=0.0002) and resolution rates for SRH, SRF, and IRF of 41.4%, 66.7%, and 29.4%, respectively. No adverse events have been reported in these patients.

Conclusions : Faricimab has demonstrated efficacy via anatomic and visual parameters and acceptable safety in previously treated patients with subretinal hemorrhages, a demographic not studied in the trials leading to FDA-approval. Future results will continue to investigate the safety and efficacy of faricimab in real-world patients suffering from nAMD-associated SRH. Latest data will be available at time of presentation.

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