What question did this study set out to answer?

To assess the effects of dual Ang-2/VEGF-A inhibition with faricimab compared to VEGF inhibition with aflibercept on PED in patients with nAMD.

March 14, 2026Open Access

Reduction in Pigment Epithelial Detachment Thickness with Faricimab vs Aflibercept 2 mg During Head-to-Head Dosing in TENAYA/LUCERNE

Key Points

To assess the effects of dual Ang-2/VEGF-A inhibition with faricimab compared to VEGF inhibition with aflibercept on PED in patients with nAMD.
Randomized trial design comparing faricimab 6 mg and aflibercept 2 mg in treatment-naïve patients.
Administered faricimab up to every 16 weeks after initial doses, versus aflibercept every 8 weeks after initial doses.
Measured changes in PED thickness and patient outcomes at week 12.
Faricimab reduced maximum PED thickness more than aflibercept in large and serous PEDs.
Significantly lower proportion of serous PED remaining at week 12 with faricimab compared to aflibercept.
Higher cumulative incidence of 50% reduction in maximum PED thickness at week 12 with faricimab.

Abstract

Purpose To evaluate the effects of dual angiopoietin-2 (Ang-2)/vascular endothelial growth factor (VEGF)-A pathway inhibition with faricimab versus VEGF pathway inhibition with aflibercept 2 mg on pigment epithelial detachment (PED) in patients with neovascular age-related macular degeneration (nAMD). Design TENAYA/LUCERNE (NCT03823287/NCT03823300) post hoc analysis. Participants Patients with treatment-naïve nAMD. Methods Patients were randomized 1:1 to faricimab 6 mg up to every 16 weeks (Q16W) (n=665) after 4 initial Q4W doses or aflibercept 2 mg Q8W (n=664) after 3 Q4W doses. PED was defined as retinal pigment epithelium (RPE) elevation width ≥350 μm and graded as predominantly/purely serous (serous PED) or predominantly/only fibrovascular (fibrovascular PED). Large PED definition: thickness ≥125 μm. Main Outcome Measures PED thickness change from baseline during initial 12-week head-to-head dosing, proportion of patients with serous PED at the end of head-to-head dosing, time to first reduction of maximum PED thickness by 50%. Results Baseline PED characteristics were similar between arms. At week 12, the adjusted mean decrease from baseline in maximum PED thickness was greater with faricimab than aflibercept 2 mg in eyes with large (–119.1 n=500 vs. –101.4 μm n=496; nominal P=0.0028), serous (–136.1 n=128 vs. –108.2 μm n=114; nominal P=0.0147), and any type (–87.9 n=644 vs. –74.5 μm n=638; nominal P=0.0067) PED at baseline. The proportion of eyes with serous PED at baseline remaining serous at week 12 was lower with faricimab than aflibercept 2 mg (4.7% vs. 13.4%; nominal P=0.0258). In eyes with large PED at baseline, the cumulative incidence of PEDs achieving time to first reduction of maximum PED thickness by 50% at week 12 was 35.3% with faricimab versus 25.7% with aflibercept 2 mg. The corresponding incidence in eyes with serous PED at baseline was 61.1% with faricimab versus 51.8% with aflibercept 2 mg. The incidence of RPE tears was low (faricimab, 2.9%; aflibercept 2 mg, 1.5%). Conclusions In TENAYA/LUCERNE, dual Ang-2/VEGF-A inhibition with faricimab elicited greater improvements in PED outcomes versus aflibercept 2 mg during head-to-head dosing. These findings are consistent with the greater drying of retinal fluid with faricimab during head-to-head dosing, which may allow for rapid treatment interval extension.

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