Real-World Efficacy and Durability of Faricimab in Aflibercept-Resistant Neovascular Age-Related Macular Degeneration

TL;DR

This study shows that switching to faricimab improves outcomes for patients with neovascular age-related macular degeneration who no longer respond to aflibercept.

Contribution

The study provides real-world evidence of faricimab's efficacy in aflibercept-resistant neovascular age-related macular degeneration patients.

Findings

Best-corrected visual acuity remained stable over 6 months.

Central subfield thickness and pigment epithelial detachment height significantly decreased.

The mean injection interval increased, reducing treatment burden.

Abstract

Objectives: This study aimed to evaluate the 6-month real-world outcomes of switching to faricimab in patients with aflibercept-resistant neovascular age-related macular degeneration (nAMD). Methods: A retrospective review was conducted on the eyes of 60 patients with aflibercept-resistant nAMD that were switched to faricimab. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) parameters, including central subfield thickness (CST), subfoveal choroidal thickness (SFCT), and both the maximum height and width of pigment epithelial detachment (PED), at baseline and 1, 3, and 6 months after switching were evaluated. The type of PED and retinal fluid were also analyzed. Results: The results showed that BCVA remained stable at month 6 (p = 0.150), while CST significantly decreased (p = 0.020), and SFCT remained unchanged (p = 0.072). The maximum PED height significantly decreased (p = 0.030), while the maximum PED width did not change (p = 0.07). The mean injection interval significantly increased from 6.8 ± 2.4 weeks before switching to 11.2 ± 1.7 weeks after switching (p = 0.068). Furthermore, the dry macula rate was 43.3% at month 6. Conclusions: Switching to faricimab in aflibercept-resistant nAMD patients showed stable visual outcomes, significant anatomical improvements, and reduced treatment burden over 6 months in real-world clinical settings.

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