Real-world outcomes of faricimab in treatment-naïve patients with neovascular age-related macular degeneration

Background To evaluate real-world efficacy, durability, and safety of faricimab in treatment-naïve Asian patients with neovascular age-related macular degeneration (nAMD). Methods Retrospective study of treatment-naïve nAMD eyes treated with faricimab at a single centre in South Korea. After four monthly loading doses, treatment intervals (Q8W, Q12W, Q16W) were assigned based on disease activity at weeks 20 and 24. Comprehensive assessments included best-corrected visual acuity (BCVA), central subfield thickness (CST), pigment epithelial detachment (PED) height, subfoveal choroidal thickness (SFCT), and intraretinal/subretinal fluid (IRF/SRF) presence. Results Eighty-eight treatment-naïve eyes were included. Mean age was 72.8 (9.0) years. At week 20, BCVA improved from 62.1 (15.4) to 69.3 (14.6) ETDRS letters (+ 7.1 letters, P < 0.001). CST decreased from 414 (150) to 280 (94) µm (− 134 μm, P < 0.001). PED height decreased from 297 (167) to 171 (116) µm (− 43%, P < 0.001). SFCT decreased from 208 (91) to 184 (83) µm (− 12%, P < 0.001), with PCV eyes showing the greatest reduction (− 32 μm, P < 0.001). IRF presence (1 mm/6 mm) decreased from 33%/34% to 7%/9%, and SRF from 78%/84% to 12%/20% at week 20. At week 60, 52.3% achieved Q16W and 67.0% achieved ≥Q12W intervals. Among 168 eyes in the safety analysis, there was 1 case of mild vitritis and 2 cases of RPE tear, with no cases of endophthalmitis or retinal vasculitis reported. Conclusions Initiation of faricimab in treatment-naïve nAMD patients resulted in favourable visual and anatomical outcomes with durable treatment intervals and a low incidence of adverse events in a real-world setting.