Aims To evaluate the efficacy and durability of faricimab for diabetic macular edema (DME) in a real-world population over 52 weeks using a personalised treatment interval protocol. Methods Retrospective cohort of centre-involving DME treated with faricimab at St Paul's Eye Unit, Liverpool (September 2022-January 2025). Exclusions: follow-up <12 weeks or anti-vascular endothelial growth factor/steroids within 3 months. Best corrected visual acuity (BCVA) and central subfield thickness (CSFT) compared at baseline, weeks 12 and 52. Results 167 patients included at baseline; 103 were treatment-naïve. Sixty-five completed 52-week follow-up. Mean BCVA gains were +7.5 letters at week 12 and +7.8 at week 52. Mean CSFT reductions were −134.5 μm at week 12 and −158.0 μm at week 52, with 80% achieving DME resolution. Extended dosing intervals (≥ 8 weeks) were assigned to 53% at week 12 and 72% at week 52. However, 24% did not receive all planned loading doses within 12 weeks. Treatment discontinued in 23% due to death, illness, or off-protocol observation. Conclusion In this unselected population, faricimab improved vision and retinal thickness in line with landmark trials. Extended dosing intervals suggest reduced treatment burden in practice. Challenges remain in patient adherence and pathway deviations.
Zelhof et al. (Tue,) studied this question.