[Real-life data of the IVI interval after switching to faricimab therapy].

Abstract

Background: For neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME), intravitreal injection (IVI) of anti-vascular endothelial growth factor (anti-VEGF) agents currently represents the standard of care. Both treatment intervals and the choice of the optimal agent are critical determinants of therapeutic outcomes.

Objective: This study evaluated the effect of switching from established anti-VEGF agents (ranibizumab, bevacizumab or aflibercept) to faricimab on injection intervals in patients with nAMD or DME.

Material and methods: Data were collected in a routine outpatient ophthalmology practice. Inclusion criteria were: (I) treatment according to a treat-and-extend protocol, (II) at least six intravitreal injections prior to switching to faricimab and (III) at least three subsequent faricimab injections. To assess disease-specific effects, patients were stratified into nAMD and DME subgroups.

Results: A total of 86 patients with a mean of 37 prior injections were included. The mean injection interval before switching to faricimab was 44 days. In the nAMD subgroup (n = 74, mean age 72 years), the interval significantly increased from 46 to 53 days (mean difference 7.45 days, p < 0.05). In the DME subgroup (n = 12, mean age 65 years), the interval significantly increased from 42 to 57 days (mean difference 15.25 days, p < 0.05). The effect size was moderate (Cohen's d = 0.56) with high statistical power (99.93%).

Conclusion: Switching to faricimab resulted in a significant extension of treatment intervals in both indications, with patients with DME deriving the greatest benefit. Limitations include the small sample size and potential selection bias. These findings suggest an improved benefit-risk profile through reduced injection frequency. Additional real-world data and meta-analyses may help identify biomarkers to further individualize anti-VEGF therapy in the future.