Propensity score analysis of treat-and-extend therapy with aflibercept versus faricimab in age-related macular degeneration

AJO International Pub Date : 2025-12-11 Epub Date: 2025-09-29 DOI:10.1016/j.ajoint.2025.100178

Akira Obana, Ryo Asaoka, Kaori Ishii, Risa Nakazawa, Kei Asaoka, Norikazu Matsumura, Yuko Gohto

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Abstract

Purpose

This study compared the 15-month outcomes of treat-and-extend (TAE) therapy with aflibercept (Af) and faricimab (Fa) in comparable cases selected by propensity score matching (PSM).

Design

Retrospective observational study.

Methods

Forty-seven eyes in the Af and Fa groups were matched for age, sex, baseline best-corrected visual acuity (BCVA), central macular thickness (CMT), age-related macular degeneration subtype, intraretinal fluid, and subretinal hyperreflective material. The TAE regimen consisted of three monthly injections, followed by monthly interval adjustments up to a maximum of four months. Changes in BCVA and CMT were assessed after 15 months.

Results

At 15 months, dry macula was achieved in 35 eyes (74.5 %) in the AF group and 37 eyes (78.7 %) in the Fa group. Both groups revealed significant improvements in the BCVA and CMT with no intergroup differences. The mean number of injections was identical (6.4 ± 0.7). No serious systemic adverse events occurred after 303 injections in either group. One Fa-treated eye developed a large subretinal hemorrhage that required displacement surgery, and no other serious ocular complications were noted.

Conclusions

PSM analysis demonstrated that Fa-based TAE was as effective as Af-based TAE in real-world practice, providing a foundation for evaluating long-term outcomes.

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阿非利西普与法利西单抗治疗与延长治疗在老年性黄斑变性中的倾向性评分分析

目的：本研究比较了通过倾向评分匹配（PSM）选择的比较病例中，阿非利西ept （Af）和faricimab （Fa）的治疗延长（TAE）治疗15个月的结果。设计回顾性观察性研究。方法对Af组和Fa组的47只眼进行年龄、性别、基线最佳矫正视力（BCVA）、黄斑中央厚度（CMT）、年龄相关性黄斑变性亚型、视网膜内液和视网膜下高反射物质的匹配。TAE方案包括每月注射3次，随后每月间隔调整，最长可达4个月。15个月后评估BCVA和CMT的变化。结果15个月时AF组35眼（74.5%）、Fa组37眼（78.7%）出现干性黄斑。两组BCVA和CMT均有显著改善，组间无差异。平均注射次数相同（6.4±0.7）次。两组注射303次后均未发生严重的全身不良事件。一只接受fa治疗的眼睛出现了大量的视网膜下出血，需要进行置换手术，没有发现其他严重的眼部并发症。结论spsm分析表明，fa - TAE与af - TAE在实际应用中同样有效，为评估长期疗效提供了基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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AJO International

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