Short-term results with faricimab in neovascular age-related macular degeneration resistant to both ranibizumab and aflibercept

Purpose

Some patients with neovascular age-related macular degeneration (nAMD) do not respond to anti-VEGF treatment or develop tolerance or tachyphylaxis. If optimal treatment response is lacking with a given drug, switching to another is a common practice. The aim of this study was to report short-term outcomes of treatment switch to faricimab in real-world patients with nAMD resistant to both aflibercept and ranibizumab.

Design

Single-center, retrospective real-world cohort study.

Methods

Chart-review of 13 eyes of 13 multi-switch patients using electronic injection database, electronic medical records, and optical coherence tomography (OCT) data from May–September 2023.

Results

Faricimab treatment led to absence of fluid (subretinal, or both subretinal and intraretinal fluid) in 31% of the eyes and a reduction of fluid in 77% of the eyes at 4 weeks following the switch. The best-corrected visual acuity did not change significantly. No ocular or systemic safety events were observed.

Conclusions

Switching to faricimab seems a reasonable option in patients with nAMD who were previously resistant to both aflibercept and ranibizumab treatment. We noted a high rate of morphological response and improvement in anatomical parameters, with nearly one-third of the patients achieving dry macula after just one injection. No change in BCVA was seen. No safety issues were noted. The durability of these results warrants additional investigations.

Trial registration

ClinicalTrials.gov, registration number: NCT06231121, date of registration: 21/01/2024, retrospectively registered.