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Introduction <p>Understanding the durability of faricimab with three monthly loading injections in a real-world clinical setting is important for optimizing treatment intervals and reducing the treatment burden. The aim of this study was to evaluate the durability and visual outcomes of a loading dose regimen consisting of three consecutive monthly faricimab injections in treatment-naïve patients with neovascular age-related macular degeneration (nAMD).</p> Methods <p>This is a retrospective, single-center cohort study using chart review and an electronic injection database, including treatment-naïve patients with nAMD aged 50 years or older who received three monthly faricimab injections between 1 November 2023 and 31 August 2024.</p> Results <p>Overall, 827 eyes of 742 patients were included in the study. Following the loading dose, the median injection-free interval was 15.0&#xa0;weeks (95% confidence interval [CI] 13.1 to 16.6). The estimated injection-free survival probabilities at 4, 6, 8, 10, 12, 14, 16, and 24&#xa0;weeks were 90.9%, 81.1%, 79.1%, 75.5%, 57.1%, 51.1%, 48.6%, and 29.4%, respectively. At 180&#xa0;days, 28.4% (<i>n</i> = 235) of eyes remained injection-free, and 21.6% (<i>n</i> = 179) were discharged from hospital-based care. At 4&#xa0;weeks post-loading, 42.6% of eyes showed improved best-corrected visual acuity (BCVA), 46.3% were stable, and 11.1% declined. The mean BCVA change was −0.082 logarithm of the minimum angle of resolution (logMAR) (95% CI −0.097 to −0.067; <i>p</i> &lt; 0.001), corresponding to a gain of approximately 4 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters.</p> Conclusions <p>A three-injection loading dose regimen of faricimab demonstrated favorable durability, with most eyes maintaining a long injection-free interval and experiencing visual improvement or stability. A routine follow-up at 4&#xa0;weeks after loading may be unnecessary in many patients, whereas 8&#xa0;weeks appear adequate. Treatment after loading can be paused for an extended period in a substantial subset of patients. Faricimab may reduce treatment burden early, while providing stabilization or improvement of visual acuity for the majority of patients with nAMD in clinical practice.</p> Trial Registration <p>ClinicalTrials.gov registration no. NCT06890026; date of registration: 16 March 2025 (retrospectively registered).</p>

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Durability of Three Monthly Loading Doses with Faricimab in Treatment-Naïve Neovascular Age-Related Macular Degeneration

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Leyla Turan,
  • Jakob Bjerager,
  • Yousif Subhi,
  • Oliver Niels Klefter,
  • Javad Nouri Hajari,
  • Miklos Schneider

摘要

Introduction

Understanding the durability of faricimab with three monthly loading injections in a real-world clinical setting is important for optimizing treatment intervals and reducing the treatment burden. The aim of this study was to evaluate the durability and visual outcomes of a loading dose regimen consisting of three consecutive monthly faricimab injections in treatment-naïve patients with neovascular age-related macular degeneration (nAMD).

Methods

This is a retrospective, single-center cohort study using chart review and an electronic injection database, including treatment-naïve patients with nAMD aged 50 years or older who received three monthly faricimab injections between 1 November 2023 and 31 August 2024.

Results

Overall, 827 eyes of 742 patients were included in the study. Following the loading dose, the median injection-free interval was 15.0 weeks (95% confidence interval [CI] 13.1 to 16.6). The estimated injection-free survival probabilities at 4, 6, 8, 10, 12, 14, 16, and 24 weeks were 90.9%, 81.1%, 79.1%, 75.5%, 57.1%, 51.1%, 48.6%, and 29.4%, respectively. At 180 days, 28.4% (n = 235) of eyes remained injection-free, and 21.6% (n = 179) were discharged from hospital-based care. At 4 weeks post-loading, 42.6% of eyes showed improved best-corrected visual acuity (BCVA), 46.3% were stable, and 11.1% declined. The mean BCVA change was −0.082 logarithm of the minimum angle of resolution (logMAR) (95% CI −0.097 to −0.067; p < 0.001), corresponding to a gain of approximately 4 Early Treatment of Diabetic Retinopathy Study (ETDRS) letters.

Conclusions

A three-injection loading dose regimen of faricimab demonstrated favorable durability, with most eyes maintaining a long injection-free interval and experiencing visual improvement or stability. A routine follow-up at 4 weeks after loading may be unnecessary in many patients, whereas 8 weeks appear adequate. Treatment after loading can be paused for an extended period in a substantial subset of patients. Faricimab may reduce treatment burden early, while providing stabilization or improvement of visual acuity for the majority of patients with nAMD in clinical practice.

Trial Registration

ClinicalTrials.gov registration no. NCT06890026; date of registration: 16 March 2025 (retrospectively registered).