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Background <p>A subset of eyes with neovascular AMD experience sub-optimal response to anti-VEGF therapy resulting in frequent injections. Faricimab has been used in this cohort due to reputed increased durability. Dosing strategies when switching vary, particularly regarding the need for a reloading phase. Our aim is to share our real-world experience of switching to faricimab with a clinician-directed dosing strategy.</p> Methods <p>Retrospective analysis of eyes with neovascular AMD switched to faricimab from a previous anti-VEGF agent in Aneurin Bevan University Health Board, South Wales. Outcomes were evaluated at one year.</p> Results <p>173 eyes from 134 patients were analysed. Mean visual acuity remained stable at one year (–0.1 letters). There was a statistically significant reduction in central subfield thickness of 30.0 μm (95% CI − 41.1 to −18.9; <i>p</i> &lt; 0.001) and an increase in injection interval of 2 weeks (95% CI 1.5 to 2.4; <i>p</i> &lt; 0.001). Within these parameters, the ‘Reloaded’ subgroup (<i>n</i> = 102) showed no clear advantage over the ‘Not reloaded’ (interval matched ± 2 weeks) subgroup (<i>n</i> = 71). The ‘Reloaded’ subgroup had received fewer prior injections and had shorter baseline injection intervals before switching.</p> Conclusions <p>Switching to faricimab was associated with stable vision, reduced macular oedema and increased injection intervals at one year. A clinician-directed dosing strategy at switching yielded comparable outcomes between subgroups, suggesting a reloading phase may not be required for all eyes. This has potential benefits for reducing demand on service capacity.</p>

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Real world experience with faricimab in switched neovascular AMD and evaluation of reloading versus interval matching regimes

  • 期刊论文

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  • 发表日期：

    2026年7月3日

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  • Ffion E. Brown,
  • Madhuparna Mitra

摘要

Background

A subset of eyes with neovascular AMD experience sub-optimal response to anti-VEGF therapy resulting in frequent injections. Faricimab has been used in this cohort due to reputed increased durability. Dosing strategies when switching vary, particularly regarding the need for a reloading phase. Our aim is to share our real-world experience of switching to faricimab with a clinician-directed dosing strategy.

Methods

Retrospective analysis of eyes with neovascular AMD switched to faricimab from a previous anti-VEGF agent in Aneurin Bevan University Health Board, South Wales. Outcomes were evaluated at one year.

Results

173 eyes from 134 patients were analysed. Mean visual acuity remained stable at one year (–0.1 letters). There was a statistically significant reduction in central subfield thickness of 30.0 μm (95% CI − 41.1 to −18.9; p < 0.001) and an increase in injection interval of 2 weeks (95% CI 1.5 to 2.4; p < 0.001). Within these parameters, the ‘Reloaded’ subgroup (n = 102) showed no clear advantage over the ‘Not reloaded’ (interval matched ± 2 weeks) subgroup (n = 71). The ‘Reloaded’ subgroup had received fewer prior injections and had shorter baseline injection intervals before switching.

Conclusions

Switching to faricimab was associated with stable vision, reduced macular oedema and increased injection intervals at one year. A clinician-directed dosing strategy at switching yielded comparable outcomes between subgroups, suggesting a reloading phase may not be required for all eyes. This has potential benefits for reducing demand on service capacity.