Real-World Outcomes of Faricimab Treatment for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema

Purpose: The purpose of this study was to assess preliminary real-world outcomes in neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) treated with intravitreal faricimab. Patients and Methods: This was a retrospective, observational consecutive-case real-world study of patients with nAMD or DME initiated on intravitreal faricimab between November 2022 and April 2023. Treatment-naïve patients and patients previously treated with alternate anti-vascular endothelial growth factor (anti-VEGF) agents were initiated on an intended treatment plan of four monthly faricimab injections as a loading regime. Efficacy was assessed across four treatment groups. Primary outcomes assessed for both cohorts were changes in best corrected visual acuity (BCVA) and central subfield thickness (CST) on optical coherence tomography (OCT). Secondary outcomes were alterations in OCT-defined structural features. Results: From 127 patients, 146 eyes received at least one dose of faricimab. Mean BCVA, measured in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, from baseline to fifth visit increased from: 59.0± 12.8 to 62.2± 14.3 in treatment-naïve nAMD; 61.1± 17.6 to 63.5± 14.8 in previously-treated nAMD; 61.1± 13.0 to 72.8± 11.5 in treatment-naïve DME; and 60.8± 14.6 to 63.3± 15.6 in previously-treated DME. Mean CST reduced in all four treatment groups between initiation to final loading dose, from: 442.8± 172.0μm to 305.2± 117.0μm (p< 0.0001) in treatment-naïve nAMD; 355.2± 115.1μm to 297.9± 92.54μm (p< 0.0001) in previously-treated nAMD; 465.8± 109.1μm to 343.1± 100.3μm (p< 0.0001) in treatment-naïve DME; and 492.5± 133.1μm to 388.5± 131.4μm (p< 0.0001) in previously-treated DME. Conclusion: Real-world outcomes showed some improvement in BCVA and CST for nAMD and DME following faricimab administration, including in patients previously treated with other anti-VEGF agents. Further work involving larger cohorts over longer periods is required to determine whether improvement is maintained, and if intervals can be extended to match those observed in clinical trials. Keywords: diabetic macular edema, neovascular age-related macular degeneration, optical coherence tomography, intravitreal, anti-vascular endothelial growth factor, faricimab