Real-world experience of intravitreal faricimab injection in previously treated neovascular age-related macular degeneration eyes: a case series.

Background: Faricimab is a novel anti-vascular endothelial growth factor agent, used to treat patients with neovascular age-related macular degeneration (nAMD). This study assessed efficacy and safety of faricimab in previously treated eyes.

Methods: This retrospective study included previously treated nAMD patients who had received at least three faricimab injections. Baseline data were collected from February 2023 to September 2023, and follow-up data were collected until April 2024. The patients were divided into two cohorts: (1) the "Loaded" cohort, which received four weekly injections prior to treatment extension, and (2) the "Interval-Matched" cohort, which continued on the same treatment interval as their previous regimen. Efficacy was evaluated based on the primary outcome measures: central subfield thickness (CST), the presence of macular fluid, and visual outcomes. Safety was assessed through the secondary outcome measure of adverse event reporting.

Result: Two hundred thirty-seven participants (297 eyes) were included with a mean age of 80.7 ± 7 years, 44% were males. 2,237 faricimab injections were administered (7.5 ± 1.9 per eye). In the loaded cohort, CST decreased from 315.1 ± 86.0 µm to 288.0 ± 63.6 µm (p < 0.001). The percentage of dry macula increased from 11.0% to 42.5% (p < 0.001). Vision changed from 67.9 ± 12.3 to 69.3 ± 13.4 letters (p = 0.002), and the injection interval extended from 5.3 ± 1.3 to 6.4 ± 2.1 weeks (p < 0.001). For the interval-matched cohort, CST decreased from 302.8 ± 57.4 µm to 291.2 ± 62.6 µm (p = 0.001). The percentage of dry macula increased from 22.5% to 47.7% (p < 0.001). Vision changed from 65.9 ± 13.8 to 65.0 ± 17.1 letters (p = 0.613), and the injection interval extended from 6.6 ± 2.8 to 7.9 ± 3.2 weeks (p < 0.001). 68 (28.7%) adverse events were reported, of which 9 (3.8%) were serious.

Conclusion: Faricimab showed beneficial anatomical response with stable vision, and less injections. The loaded cohort exhibited superior outcomes but needed more injections.