Retinal and choroidal efficacy of switching treatment to faricimab in recalcitrant neovascular age related macular degeneration

Sci Rep. 2024 Apr 26;14(1):9600. doi: 10.1038/s41598-024-59632-0.

Abstract

Aim of this study was to evaluate the efficacy of switching treatment to faricimab in neovascular age-related macular degeneration (nAMD) from other anti-VEGF agents. Fifty-eight eyes of fifty-one patients with nAMD and a full upload series of four faricimab injections were included. Demographic data, multimodal imaging and treatment parameters were recorded. The primary outcome measures were changes in central subfield thickness (CST) and subfoveal choroidal thickness (SFCT). A subgroup analysis was performed for eyes with prior ranibizumab (R) or aflibercept (A) treatment. Mean injection intervals before and after switching were comparable (33.8 ± 11.2 vs. 29.3 ± 2.6 days; p = 0.08). Mean CST of 361.4 ± 108.1 µm prior to switching decreased significantly to 318.3 ± 97.7 µm (p < 0.01) after the third faricimab injection, regardless of prior anti-VEGF treatment (p < 0.01). Although SFCT slightly improved for the whole cohort from 165.8 ± 76.8 µm to 161.0 ± 82,8 µm (p = 0.029), subgroup analysis did not confirm this positive effect (subgroup R: p = 0.604; subgroup A: p = 0.306). In patients with a suboptimal response to aflibercept or ranibizumab in nAMD, farcimab can improve CST and slightly improve or maintain SFCT. Further prospective randomized trials are warranted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors* / administration & dosage
  • Angiogenesis Inhibitors* / therapeutic use
  • Choroid* / diagnostic imaging
  • Choroid* / drug effects
  • Choroid* / pathology
  • Drug Substitution
  • Female
  • Humans
  • Intravitreal Injections
  • Macular Degeneration / drug therapy
  • Macular Degeneration / pathology
  • Male
  • Ranibizumab* / administration & dosage
  • Ranibizumab* / therapeutic use
  • Receptors, Vascular Endothelial Growth Factor* / administration & dosage
  • Receptors, Vascular Endothelial Growth Factor* / therapeutic use
  • Recombinant Fusion Proteins* / administration & dosage
  • Recombinant Fusion Proteins* / therapeutic use
  • Retina / diagnostic imaging
  • Retina / drug effects
  • Retina / pathology
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / drug effects

Substances

  • Ranibizumab
  • Recombinant Fusion Proteins
  • aflibercept
  • Angiogenesis Inhibitors
  • Receptors, Vascular Endothelial Growth Factor
  • Vascular Endothelial Growth Factor A