ASRS 2023: The real-world use of faricimab

Theodore Leng, MD, sat down with David Hutton of Ophthalmology Times®, to discuss his ASRS presentation on how the real-world use of faricimab.

Video transcript

Editor’s note: This transcript has been edited for clarity.

David Hutton:

I'm David Hutton of Ophthalmology times. ASRS recently held its annual scientific meeting in Seattle. Faricimab was a hot topic at the event. And I'm joined today by Dr. Theodore Leng, who presented data at the meeting.

Theodore Leng, MD:

Thank you so much for joining us today. Tell us about your presentation.
Thank you so much for having me today. It was really wonderful to meet with friends and colleagues in Seattle, and especially to present this exciting data. So what we did is we looked at the real-world use of faricimab, which as you mentioned, was recently approved as of January 2022. And the goal of this study was to look at the real-world experience of faricimab in the first nine months after its release.

This study was sponsored by Genentech and looked at all eyes in the American Academy of Ophthalmology's Iris Registry, from January 2022, to September 2022. And as a reminder, the Iris Registry is the largest specialty specific data set in all of medicine, with 35 million patients in it. And so we were able to include 17,503 eyes in this study, which spanned 9 months. And I think there are 4 key takeaways from this study. The first one is that, as expected, most patients were not treatment-naive, in the early days of a new agent on the market. So 6% were treatment-naive and 94% were switchers from another agent. The majority of them actually switched from aflibercept, which comprised about 67% of the patients that we have in our cohort. Of the patients that switched, the mean interval between injections was about 6 weeks, in the previous 12 months leading up to the switch.

So the second kind of big takeaway was that 50%, or greater than 50% of the eyes were able to achieve an extended interval of over 6 weeks after only 2 injections of farcimab. So patients did not follow, or physicians didn't follow the, you know, the protocol eyes loading doses that we had in the [inaudible] studies, but actually using more real-world extension earlier. And, you know, 55% of previously treated eyes and 43% of treatment-naive eyes were able to extend after 2 injections of faricimab.

The third finding we saw was that the patients that were treatment-naive, had improved vision after 4 injections in the study, with a mean gain of about 2 letters on average.

And the last fourth finding that we saw that was interesting, especially in these eyes was that – as retinal physicians, we are actually starting patients with relatively good vision. So almost half the patients have 20/40 are better vision at a time of faricimab initiation, which is much higher than in the pivotal phase 3 trials. Were there about 14% of 20/32 or better. And this speaks to; One our comfort level with anti-VEGF agents in general, and two just the fact that I think we were looking for other reasons to initiate a new therapy, maybe longer duration of activity, or potentially uncontrolled leakage in the presence of monthly therapy. So as I mentioned, this was just the first 9 months of data that came out since the medications were released and approved by the FDA. Of course, more data cuts will be forthcoming in future presentations. Thank you so much for this opportunity.