Faricimab in Treatment-Naïve nAMD: Regional UK Real-World Experience

Neovascular age-related macular degeneration (nAMD) is a progressive retinal disease leading to significant vision loss. Previous standard of care, anti-vascular endothelial growth factor (anti-VEGF) monotherapy, requires frequent injections to maintain efficacy. Faricimab, which targets angiopoietin-2 and VEGF-A, has shown efficacy in patients with nAMD with extended dosing intervals in randomised controlled trials (RCTs). However, results from RCTs are often challenging to replicate in real-world practice. This study aimed to explore outcomes in patients with nAMD treated with faricimab in real-world settings in the UK. Newly diagnosed patients with nAMD receiving first-line faricimab between 2022 and 2024 were examined across six UK sites in England and Wales. Patients were generally treated per the National Institute of Health and Care Excellence (NICE)-recommended protocol for approximately 1 year, with some deviations at individual sites. Outcomes reported included best-corrected visual acuity (BCVA), optical coherence tomography (OCT) fluid, retinal thickness, treatment intervals and safety. Data were analysed separately for each site; adverse event incidence was pooled. The total number of eyes treated was 505 from 473 patients. Baseline characteristics were similar across sites, with a mean age of 77.0–82.0 years. BCVA, OCT fluid and retinal thickness improvements from baseline were observed across all sites, irrespective of timepoint or treatment protocol. BCVA improvements from baseline ranged from + 5.1 to + 7.7 letters at the first post-loading visit and from + 5.0 to + 8.2 letters at 12 months. Mean change in retinal thickness from baseline ranged from − 92.3 to − 127.7 μm at 12 months. Most patients received faricimab at intervals of ≥ 8 weeks following the loading phase. The pooled incidence of adverse events was low. Faricimab demonstrated consistent visual and anatomical improvements in real-world UK settings across a heterogeneous group of patients with nAMD. Further real-world studies will be essential to confirm long-term safety and effectiveness in clinical practice. Neovascular age-related macular degeneration (nAMD) is a serious eye condition that often leads to loss of vision. Previous treatment options for nAMD required patients to receive injections in the eye every 4 weeks. This creates a time burden and emotional burden for both patients and their caregivers. Faricimab is a new treatment option that may reduce this burden. We looked at data across six UK hospitals to investigate the effects of faricimab in patients with nAMD who had not received any previous treatment. Patients included in the study were treated with faricimab for around 1 year between 2022 and 2024. Across the six UK hospitals, we found that treating patients with nAMD with faricimab consistently led to improvements in vision, reduced the amount of fluid in the eye, and reduced the thickness of the retina. These outcomes demonstrate reductions in patients’ disease activity. Most patients in our study were able to receive injections less frequently over time: typically every 8 weeks or more. There were few side effects of faricimab treatment. In summary, our results support that faricimab is effective and safe for treating nAMD in a real-world setting, consistent with results from previous clinical trials. This is important because patients in the real world are usually more diverse, and conditions are more likely to vary, compared to clinical trials. Further research is important to confirm these results over longer periods.