Abstract
Purpose :
Recently, faricimab (FAR) is approved to treat diabetic macular edema (DME). It inhibits both vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-2, potentially restoring the stabilizing effect of Ang-1 on blood vessels. However, the specific pharmacological dynamics of these factors during clinical treatment have not been well documented. This study aimed to measure the concentrations of VEGF, Ang-1, and Ang-2 in the aqueous humor at the time of injection in treatment naive DME patients receiving faricimab during the induction phase and retrospectively analyze the data.
Methods :
A total of 26 patients (35 eyes) with treatment naïve DME received faricimab injections monthly for three consecutive months. Aqueous humor samples were collected in each injection and stored at -80°C, and their concentrations were quantified using multiple enzyme-linked immunosorbent assay (ELISA) (Luminex). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were extracted from the medical records for analysis.
Results :
Before treatment, BCVA and OCT measurements were 0.32±0.31 logMAR and 496.6±150.9 µm, respectively. By the third injection, BCVA improved significantly to 0.23±0.29 logMAR, and CMT decreased to 376.9±136.5 μm. Baseline aqueous humor concentrations were 114.6±170.1 pg/ml for VEGF, 163.0±267.0 pg/ml for Ang-2, and 45.4±14.3 pg/ml for Ang-1. Following faricimab treatment, VEGF and Ang-2 concentrations rapidly decreased, reaching 18.6±97.7 pg/ml and 38.8±36.4 pg/ml, respectively, at the third injection. Ang-1 levels also decreased to 39.7±16.7 pg/ml.
Conclusions :
During the induction phase, faricimab treatment for DME suppresses VEGF and Ang-2 immediately, but does not elevate Ang-1; instead, there is a potential for Ang-1 suppression.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.