Outcomes After Switching to Faricimab in Neovascular Age-Related Macular Degeneration: Data From the Fight Retinal Blindness! Registry.

Abstract

Background: We aimed to describe 1-year outcomes of eyes switched to faricimab from first-generation vascular endothelial growth factor (VEGF) inhibitors for neovascular age-related macular degeneration (nAMD) in routine care.

Methods: Multicentre, observational study of 383 eyes tracked in the Fight Retinal Blindness! registry switched to faricimab from aflibercept 2 mg, ranibizumab, or bevacizumab between 1st January-1st August 2023 in Australia.

Results: One-year completion rates were high (335/383 [88%]). The proportion of choroidal neovascular (CNV) lesions graded as inactive increased from 39% at switch to 63% at 12 months (p < 0.01). Mean visual acuity (95% Confidence Interval) decreased from 70.0 (68.6, 71.5) to 68.4 (66.7, 70.1) logarithm of the minimum angle of resolution letters (both approx. 6/12). Mean treatment intervals increased from 7.2 to 10.5 weeks (p < 0.01). Eyes with active CNV at switch maintained mean VA -0.5 (-1.7, +0.7) letters; 50% were inactivated at 12 months. Eyes with inactive CNV at switch lost -3.5 (-5.0, -1.9) letters; 15% had reactivation at 12 months. Switchback occurred in 64/383 eyes (17%), predominantly to aflibercept 2 mg, that lost -1.9 letters without interval change at 12 months. Adverse outcomes were in keeping with previous reports, with no cases of occlusive retinal vasculitis.

Conclusions: We found that faricimab inactivated a significant proportion of CNV lesions that had been active using 1st generation VEGF inhibitors, with a significant extension of the treatment interval. A small reduction in VA occurred in switchers and eyes not switched through the same period.