Up to 10‐month outcomes of faricimab in treating treatment‐refractory wet age‐related macular degeneration

Aims/Purpose: Wet Age‐Related Macular Degeneration (ARMD) represents a significant irreversible cause of blindness worldwide. Current treatment options are limited to anti‐VEGF therapy, which has shown limited success in halting disease progression. A novel anti‐VEGF therapy, Faricimab, has been suggested to revolutionise these outcomes. This study aimed to evaluate the effectiveness of Faricimab in treating Wet ARMD.

Methods: This retrospective cohort study was conducted. Inclusion criteria: all patients with a diagnosis of Wet ARMD who received at least 4 loading‐doses of Faricimab between January 2023 and May 2024 at Watford General Hospital, United Kingdom. Exclusion criteria: Patients who did not receive any anti‐VEGF treatments prior to starting Faricimab. Data on visual acuity (VA) and OCT images were collected for their first and last injections. OCTs were analysed to evaluate the thickness of central retinal fluid (CRF), pigment epithelial detachment (PED) and sub‐retinal fluid (SRF). Data was compared between increasing number of Faricimab injections, OCT thicknesses and visual outcomes.

Results: 40 patients (45 eyes) were identified and included in the study. The mean change of thickness between first and last injections in patients were: +1.18 ± 35.7 % increase in CRF, ‐1.65 ± 39.7 % decrease in PED, and ‐40.053 ± 52.4 % of the patients who had SRF. There was no significant difference in CRF or PED thickness changes between 4‐6 injections compared to 8‐10 injections (p: 0.39 and p: 0.17). Average VA worsened, with a mean of 0.065 ± 0.475 increase in LogMAR.

Conclusions: This study demonstrates the limited effectiveness of Faricimab in treating wet ARMD. There was no significant decrease in CRF and PED. However, there was a 40% decrease in SRF for patients affected by pre‐existing SRF before the 4th injection. Current literature indicates a link between a reduction in SRF and a subsequent worsening in VA¹, as seen in our study. Further data needs to be collected to assess the effectiveness of Faricimab in treating ARMD.

References: 1 Siedlecki J et al. Impact of Sub‐Retinal Fluid on the Long‐Term Incidence of Macular Atrophy in Neovascular Age‐related Macular Degeneration under Treat & Extend Anti‐Vascular Endothelial Growth Factor Inhibitors. Sci Rep. 2020 May 15; 10(1): 8036. doi: 10.1038/s41598‐020‐64901‐9.