Real-world six-month outcomes in patients switched to faricimab following partial response to anti-VEGF therapy for neovascular age-related macular degeneration and diabetic macular oedema

Abstract Background Landmark studies reported on faricimab efficacy and safety predominantly in treatment naïve patients, but outcomes following switch from other anti-VEGF therapies are lacking. We evaluated patients switched to faricimab who had previously shown a partial response to other anti-VEGF injections for neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO). Methods Retrospective study at the Oxford Eye Hospital. Patients switched to faricimab from January to April 2023 with six months follow-up were identified via electronic medical records. Results A total of 116 patients (151 eyes) were included. In 88 patients with nAMD (107 eyes), mean visual acuity remained stable: 62±17 ETDRS letters at baseline; 62±18 at six months ( p > 0.05). Central subfield thickness (CST) reduced from 294 ± 73 μm to 270 ± 53 μm ( p < 0.05) at six months. Subretinal or intraretinal fluid was present in 102 eyes (95%) at baseline and 75 eyes (70%) at follow-up ( p < 0.05). Pigment epithelial detachment height decreased from 233 ± 134 μm to 188 ± 147 μm ( p < 0.05). Mean treatment interval increased by 1.7 weeks ( p < 0.05) and was extended in 61 eyes (57%) at six months. In 28 patients with DMO (44 eyes), visual acuity remained stable: 69 ± 15 letters at baseline; 70±15 at six months ( p > 0.05). CST reduced from 355 ± 87 μm to 317 ± 82 μm ( p < 0.05). Mean treatment interval increased by 1.4 weeks ( p < 0.05) and was extended in 21 eyes (46%) by six months. Conclusions Switching to faricimab in treatment resistant eyes led to improved anatomical response and extended treatment interval in a significant proportion of patients. Ongoing review of real-world data will inform longer-term outcomes of safety and effectiveness.