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Study finds faricimab effective for nAMD patients unresponsive to other anti-VEGF treatments
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Key Takeaways
- Faricimab targets VEGF-A and Ang-2, enhancing vascular stability and reducing inflammation in nAMD patients unresponsive to other treatments.
- Significant improvements in visual acuity, central subfield thickness, and pigment epithelial detachment height were observed after six months of faricimab treatment.
This research team evaluated the effectiveness of switching patients to faricimab treatment by assessing their outcomes after 6 months of treatment in a retrospective chart review that included 102 patients with nAMD who had had suboptimal responses to other anti-VEGF therapies.
(Image Credit: AdobeStock/Trsakaoe)
Korean investigators reported that faricimab (Vabysmo, Roche/Genentech) in a real-world setting works well for patients with neovascular age-related macular degeneration (nAMD) refractory to other anti-vascular endothelial growth factor (VEGF) treatment,1 according to Seung Chul Baek, MD, Areum Jeong, MD, and Min Sagong, MD, PhD, from the Department of Ophthalmology, Yeungnam University College of Medicine, and Yeungnam Eye Center, Yeungnam University Hospital, both in Daegu, Korea.
In commenting on treating nAMD, the investigators explained, “While most patients respond well to standard VEGF treatments, some patients exhibit incomplete responses, with retention or reaccumulation of retinal fluid, highlighting the need for more effective therapeutic options.”
Faricimab offers these patients an advantage of its dual mechanism of action, in that the drug targets VEGF-A and angiopoietin-2 (Ang-2), - 2 factors in neovascularization and vascular instability in nAMD.2 “By binding VEGF-A and Ang-2 and inhibiting both downstream signaling pathways, faricimab enhances vascular stability and reduces inflammation in the retina, potentially improving fluid control and extending the treatment interval compared to other anti-VEGF agents used for nAMD,” they stated.
Up to now, they explained, data are lacking regarding the clinical outcomes of patients previously treated with other anti-VEGF therapies who have been switched to faricimab due to suboptimal responses or treatment burden and emphasized, “The real-world efficacy and safety of switching patients with treatment-resistant nAMD to faricimab must be verified to optimize treatment strategies and identify unmet needs in nAMD management.”
This research team evaluated the effectiveness of switching these patients to faricimab treatment by assessing their outcomes after 6 months of treatment in a retrospective chart review that included 102 patients with nAMD who had had suboptimal responses to other anti-VEGF therapies.
The study patients had had persistent fluid on optical coherence tomography despite injection frequencies of every 4 to 8 weeks before the switch to faricimab.
The investigators measured changes in the best-corrected visual acuity (BCVA), central subfield thickness (CST), subfoveal choroidal thickness, maximum pigment epithelial detachment (PED) height, and fluid status at baseline and 1, 3, and 6 months after the patients began faricimab. The treatment intervals before and after switching were compared.
Effect of faricimab at 6 months
At the 6-month timepoint, the investigators reported that the mean BCVA improved (0.50 ± 0.12 logarithm of the minimum angle of resolution [logMAR] to 0.45 ± 0.10 logMAR, p = 0.030), along with a decrease in the mean CST from 353.3 ± 40.5 μm at baseline to 311.4 ± 35.4 μm (p = 0.012). The mean PED height also decreased from 309.1 ± 32.1 μm at baseline to 279.1 ± 30.8 μm at 6 months (p = 0.040). The mean choroidal thickness did not decrease significantly after the treatment change.
The patients’ mean treatment interval almost doubled from 5.7 ± 1.4 to 10.4 ± 1.8 weeks after switching to faricimab (p=0.001).
The investigators commented, “A dry macula was achieved in 43.1% of patients, while 76.5% were classified as good responders, 6.5% as partial responders, and 17% reverted to other anti-VEGF treatments due to no response.”
They concluded, “Switching to faricimab can result in significant visual and anatomical improvements in patients with nAMD who are refractory to other anti-VEGF treatments. Faricimab also provides effective retinal fluid control and extends the treatment interval, making it a promising option for managing nAMD in the long term.”
References
Baek SC, Jeong A, Min Sagong M. Real-world efficacy of faricimab in patients with treatment-resistant neovascular age-related macular degeneration: outcomes at six months. J Retina. 2024;9:150-155.
Khanani AM, Patel SS, Ferrone PJ, et al. Efficacy of every four monthly and quarterly dosing of faricimab vs ranibizumab in neovascular age-related macular degeneration: The STAIRWAY phase 2 randomized clinical trial. JAMA Ophthalmol. 2020;138:964-72.
