Initial Real-World Experience with Faricimab in Treatment-Resistant Neovascular Age-Related Macular Degeneration

Purpose: To evaluate the initial efficacy and safety of intravitreal faricimab in eyes previously treated for neovascular age-related macular degeneration (nARMD).Patients and methods: A retrospective review of all patients with nARMD previously treated with anti-vascular endothelial growth factor (anti-VEGF) injections who received at least 3 intravitreal faricimab injections with at least 3 months of follow-up.Results: A total of 190 eyes were included. Patients received a mean of 34.2 +/- 23 anti-VEGF injections over 182.41 +/- 128 weeks prior to switching to faricimab. Patients then received a mean of 6.99 +/- 2.3 faricimab injections with an average 34.88 +/- 8.2 weeks of follow-up. The mean best corrected visual acuities improved from 0.33 +/- 0.32 logMAR approximate to 20/43 to 0.27 +/- 0.32 logMAR approximate to 20/37 (P=0.0022). The central subfield thickness (CST) improved from 312 +/- 87 mu m to 287 +/- 71 mu m (P<0.0001). At the last clinical visit, 24% had no subretinal fluid or intraretinal fluid on optical coherence tomography. The mean dosing interval between the last two consecutive faricimab injections (7.64 +/- 6.2 weeks) was significantly longer than that for ranibizumab (5.16 +/- 2.0 weeks, P<0.001) or aflibercept (5.57 +/- 3.6 weeks, P<0.001). No patients developed idiopathic intraocular inflammation.Conclusion: Intravitreal faricimab was associated with improved vision and CSTs, even in treatment-resistant nARMD eyes. The mean last dosing interval for faricimab was longer than for ranibizumab or aflibercept. No significant adverse events were directly attributed to faricimab during the study.