Real-World 12 and 18-Month Outcomes of Faricimab in Patients Previously Treated for Neovascular Age-Related Macular Degeneration

Introduction: Faricimab was demonstrated to be efficacious in treatment-naïve patients. We evaluated real-world outcomes of faricimab in patients with neovascular age-related macular degeneration (nAMD) who responded suboptimally to other anti-VEGF treatment or had a high treatment burden. Method: Single-centre retrospective study of nAMD patients switched to faricimab from September to December 2022 with a minimum of 12 months’ follow-up. Main outcomes included best-corrected visual acuity (BCVA), central subfield thickness (CST), and treatment intervals at 12 and 18 months. Results: A total of 71 eyes (62 patients) and 60 eyes (53 patients) with sufficient follow-up data were included in the analysis at 12 and 18 months respectively. Median BCVA decreased from 68 ETDRS letters (IQR 57–74) to 66 (IQR 55–75) at 12 months (p = 0.119) and 67 (IQR 55–73) at 18 months (p = 0.009). Median CST decreased from 296 µm (IQR 270–339) at baseline to 273 µm (245–313, p < 0.001) and 263 µm (240–300, p < 0.001) at 12 and 18 months respectively. Overall, 5.6% of eyes had a dry macula at baseline, compared to 26.8% (p = 0.002) and 31.7% (p = 0.001) at 12 and 18 months respectively. Mean treatment interval increased from 5.2 ± 1.6 weeks at baseline, to 7.4 ± 2.8 weeks (p < 0.001) at 12 months, and 7.5 ± 3.1 weeks (p < 0.001) at 18 months. One case of hypertensive anterior uveitis and one case of post-injection hypotony were reported during follow-up. Conclusions: Switching to faricimab for nAMD was associated with a decline in visual acuity that was not clinically meaningful, with the majority of eyes avoiding moderate visual loss. Anatomical outcomes improved, and treatment intervals were extended over 18 months.