# The Implementation of Faricimab in East Lancashire NHS Trust: Highlighting the Real-World Efficacy and Safety in Patients With Neovascular Age-Related Macular Degeneration

## TL;DR

This study shows that faricimab injections improve retinal thickness in patients with neovascular age-related macular degeneration, with a good safety profile.

## Contribution

The study provides real-world evidence of faricimab's efficacy and safety in both treatment-naive and treatment-resistant nAMD patients.

## Key findings

- Faricimab significantly reduced central retinal thickness in all patient groups.
- Visual acuity improved in nearly half of the patients, with no major safety concerns observed.
- No cases of vasculitis or vein occlusion were reported during the study.

## Abstract

Purpose: To report the safety and efficacy of intravitreal faricimab injections (IVTF) in both treatment-naïve and treatment-resistant patients with neovascular age-related macular degeneration (nAMD).

Patients and methods: This study was a retrospective real-world evidence trial where patients with nAMD were given IVTF. Group 1 (treatment-naïve) and group 2 (switch loading dose, SLD) were given a course of four loading doses of IVTF four weeks apart. Group 3 (switch pro re nata, SPRN) was given a single IVTF and then reviewed at eight weeks. The outcome was based on visual acuity (VA) and optical coherence tomography (OCT), showing central retinal thickness (CRT), subretinal, and intraretinal fluid.

Results: A total of 99 eyes from 89 patients were included. A total of 350 IVTF were given. The mean follow-up duration was 6.33 ± 1.11 months (range: 2-8 months). The mean change in CRT at final follow-up was -127.09 ± 97.39 µm (p < 0.001) for naïve eyes, -115.59 ± 145.02 µm (p < 0.001) for SLD, and -57.61 ± 58.06 µm (p < 0.001) for SPRN. The mean VA change was -3.47 ETDRS (Early Treatment Diabetic Retinopathy Study) (p = 0.256) for naïve eyes, -0.79 (p = 0.45) for SLD, and +1.25 (p = 0.304) for SPRN. A total of 48 eyes (48.48%) had better VA, 22 (22.22%) had no change in VA, and 29 (29.29%) had worse VA. One patient developed bilateral sterile intraocular inflammation.

Conclusion: IVTF was associated with an improvement in CRT in both treatment-naive and treatment-resistant nAMD patients. There was no evidence of vasculitis or vein occlusion, highlighting the safety of faricimab in our real-world study.