TY  - JOUR
Y1  - 2025/01/02/
AV  - restricted
VL  - 9
SP  - 22
EP  - 30
TI  - Real-World 1-Year Outcomes of Treatment-Intensive Neovascular Age-Related Macular Degeneration Switched to Faricimab
IS  - 1
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UR  - http://dx.doi.org/10.1016/j.oret.2024.07.020
PB  - Elsevier BV
N2  - Purpose:
To report 1-year anatomic and functional real-world outcomes of patients with treatment-intensive neovascular age-related macular degeneration (nAMD) switched to faricimab.

Design:
Retrospective multicenter cohort study.

Subjects:
Consecutive nAMD patients on 4-weekly treatment interval with either ranibizumab or aflibercept 2 mg in the last 3 visits within a treat-and-extend protocol (high treatment burden) before switch to faricimab at Moorfields Eye Hospital between September 5, 2022 and December 5, 2022.

Methods:
Patients with nAMD switched to faricimab were identified from electronic medical records and those who met criteria of high treatment burden were included. Data collected included preswitch and postswitch visual acuity (VA), treatment intervals, baseline macular morphology, central subfield thickness (CST), macular fluid status, and adverse events.

Main Outcome Measures:
Visual acuity, CST, presence of intraretinal fluid, subretinal fluid, and injection intervals over 1 year after switch to faricimab.

Results:
A total of 130 of 286 (45.5%) eyes met inclusion criteria of being switched due to high treatment burden and 117 were included in analysis. Before switch, these eyes received mean total number of injections of 33.4 ± 19.6 over a mean of 51.3 ± 34.9 months. Mean number of injections in 12 months preceding switch was 10.1 ± 1.6 and mean interval of the preceding 3 injections was 4.2 ± 0.3 weeks. Mean VA, CST, and percentage of patients with dry macula before switch were 66.0 ± 11.9 ETDRS letters, 259.6 ± 76.0 ?m and 18.3% respectively. After switch, there was no statistical difference in mean VA throughout follow-up period. Mean CST statistically significantly reduced after the third faricimab injection and at 12 months by 20.0 ?m (P = 0.035) and 22.1 ?m (P = 0.041) respectively. Mean treatment intervals increased to 6.9 ± 2.3 weeks (P < 0.005) at 12 months with 42.9% and 11.4% of patients being on ?8-weekly and ?12-weekly treatment intervals, respectively.

Conclusions:
At 12 months, nAMD patients with previous record of high treatment burden when switched to faricimab maintained VAs and improved anatomic outcomes on extended treatment intervals. Physician bias is inherent in these types of observational studies so a prospective, randomized, controlled trial is recommended to validate these findings.

Financial Disclosure(s):
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
ID  - discovery10196073
A1  - Sim, Sing Yue
A1  - Chalkiadaki, Evangelia
A1  - Koutsocheras, Georgios
A1  - Nicholson, Luke
A1  - Sivaprasad, Sobha
A1  - Patel, Praveen J
A1  - Selvam, Senthil
A1  - Pal, Bishwanath
A1  - Keane, Pearse A
A1  - Bhatia, Bhairavi
A1  - Hamilton, Robin
A1  - Logeswaran, Abison
A1  - Tufail, Adnan
A1  - Gurbaxani, Avinash
A1  - pal, Bishwanath
A1  - Egan, Catherine
A1  - Bessant, David
A1  - Thomas, Dhanes
A1  - Ling, Heng
A1  - Huemer, Josef
A1  - Basheer, Khadijah
A1  - Balaskas, Konstantinos
A1  - Bouras, Konstantinos
A1  - Da Cruz, Lyndon
A1  - Natkunarajah, Mythili
A1  - Okhravi, Narciss
A1  - Islam, Niaz
A1  - Desai, Parul
A1  - Addison, Peter
A1  - Rajendram, Ranjan
A1  - Esposti, Simona
A1  - Heeren, Tjebo
A1  - Rahman, Waheeda
A1  - Khan, Yasir
A1  - Ockrim, Zoe
A1  - Saihan, Zubin
JF  - Ophthalmology Retina
ER  -