Twelve-Month Real-World Outcomes of Faricimab for Treatment-Naive Neovascular AMD in Australia

Abstract

To provide insights into the effectiveness and safety of faricimab for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD). A retrospective cohort study using a prospectively-designed registry. Treatment-naïve eyes with nAMD in Australia starting treatment with faricimab between Jan 2023-Sep 2024 were included. Controls were treatment-naïve eyes starting with aflibercept 2 mg before 2022. Visual acuity (VA), macular neovascularisation activity, time to first inactivity, number of injections, injection intervals and number of visits at 12 months were investigated. Eyes treated with faricimab versus aflibercept 2 mg were compared using overlap weighting. The main outcome measure was the 12-month VA change. Twenty-three practitioners treated 160 eyes with a 4-letter gain in VA (mean, 61.5-65.5 letters) and 48% attaining a dosing interval of ≥ 12 weeks, although 22% were still treated at < 8 weekly intervals. The small proportion (6.9%) of eyes switching to another agent had improved vision but were mostly active when switching off faricimab. Eyes received 7.2 injections (mean) at 7.4 visits (mean), receiving treatment at 98% of visits indicating a strongly proactive treatment regimen. Most (71%) lesions became inactive by 12 months with a mean time to inactivation of 10.3 weeks. Eyes starting faricimab had a significantly higher inactivation rate with more eyes reaching the last injection interval of ≥ 12 weeks than those starting aflibercept 2 mg. These findings indicate that faricimab is safe and effective for treatment-naive eyes with nAMD. Faricimab had a stronger effect on nAMD lesion activity than aflibercept 2 mg.