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Background <p>In neovascular age-related macular degeneration (nAMD), persistent disease activity despite anti-VEGF therapy is common. Switching to faricimab may improve outcomes and extend treatment intervals in treatment-resistant patients, but long-term real-world data remain limited.</p> Methods <p>In this retrospective, single-centre study, 43 eyes of 38 patients with treatment-resistant nAMD were switched to faricimab and followed for up to 24 months. Insufficient disease control was defined as inability to extend treatment intervals beyond 8 weeks under a treat-and-extend regimen. Outcomes included best-corrected visual acuity (BCVA), central subfield thickness (CST), pigment epithelial detachment (PED) height, fluid status, and treatment intervals. Longitudinal changes were analysed using mixed-effects models. Exploratory analyses of baseline and early response predictors were performed.</p> Results <p>Mean BCVA remained stable throughout follow-up, with no significant change from baseline at any time point (<i>p</i> &gt; 0.05). CST decreased significantly at all visits, ranging from − 45.8&#xa0;μm (95% CI − 65.3&#xa0;μm to − 26.3&#xa0;μm) at 1 month to − 52.3&#xa0;μm (95% CI − 73.7&#xa0;μm to − 30.8&#xa0;μm) at 24 months (<i>p</i> &lt; 0.001). PED height decreased at 1 month (− 19.0&#xa0;μm; 95% CI − 33.6&#xa0;μm to − 4.4&#xa0;μm, <i>p</i> = 0.011) and remained reduced from 12 to 24 months, ranging from − 25.9&#xa0;μm (95% CI − 39.7&#xa0;μm to − 12.1&#xa0;μm, <i>p</i> &lt; 0.001) to − 49.1&#xa0;μm (95% CI − 65.1&#xa0;μm to − 33.0&#xa0;μm, <i>p</i> &lt; 0.001). Presence of subretinal fluid decreased significantly at all time points, with odds ratios (OR) ranging from 0.064 (95% CI 0.01 to 0.41, <i>p</i> = 0.004) at 1 month to 0.012 (95% CI 0.01 to 0.10, <i>p</i> &lt; 0.001) at 24 months, whereas intraretinal fluid showed a variable response, with a significant reduction observed at 3 months only (OR 0.204, 95% CI 0.05 to 0.79, <i>p</i> = 0.021). The proportion of eyes with a dry macula increased from 0% at baseline to 23.1% at 12 months and 24.0% at 24 months. Treatment intervals extended from 5.9 ± 1.2 weeks before switch to 8.7 ± 2.6 weeks at 12 months (<i>p</i> &lt; 0.001) and 10.6 ± 3.0 weeks at 24 months (<i>p</i> &lt; 0.001). No adverse events were observed.</p> Conclusion <p>Switching to faricimab was associated with improved anatomical outcomes and extended treatment intervals while maintaining stable visual acuity, suggesting benefits primarily related to anatomical control and reduced treatment burden.</p>

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Real-world outcomes after switching to faricimab in previously treated neovascular age-related macular degeneration: longitudinal outcomes up to 24 months

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  • 发表日期：

    2026年6月23日

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  • Daniel Egger,
  • Florian Amesbauer,
  • Hamza Mohamed,
  • Konstantin E. Thiel,
  • Reinhard Angermann,
  • Sebastian M. Waldstein

摘要

Background

In neovascular age-related macular degeneration (nAMD), persistent disease activity despite anti-VEGF therapy is common. Switching to faricimab may improve outcomes and extend treatment intervals in treatment-resistant patients, but long-term real-world data remain limited.

Methods

In this retrospective, single-centre study, 43 eyes of 38 patients with treatment-resistant nAMD were switched to faricimab and followed for up to 24 months. Insufficient disease control was defined as inability to extend treatment intervals beyond 8 weeks under a treat-and-extend regimen. Outcomes included best-corrected visual acuity (BCVA), central subfield thickness (CST), pigment epithelial detachment (PED) height, fluid status, and treatment intervals. Longitudinal changes were analysed using mixed-effects models. Exploratory analyses of baseline and early response predictors were performed.

Results

Mean BCVA remained stable throughout follow-up, with no significant change from baseline at any time point (p > 0.05). CST decreased significantly at all visits, ranging from − 45.8 μm (95% CI − 65.3 μm to − 26.3 μm) at 1 month to − 52.3 μm (95% CI − 73.7 μm to − 30.8 μm) at 24 months (p < 0.001). PED height decreased at 1 month (− 19.0 μm; 95% CI − 33.6 μm to − 4.4 μm, p = 0.011) and remained reduced from 12 to 24 months, ranging from − 25.9 μm (95% CI − 39.7 μm to − 12.1 μm, p < 0.001) to − 49.1 μm (95% CI − 65.1 μm to − 33.0 μm, p < 0.001). Presence of subretinal fluid decreased significantly at all time points, with odds ratios (OR) ranging from 0.064 (95% CI 0.01 to 0.41, p = 0.004) at 1 month to 0.012 (95% CI 0.01 to 0.10, p < 0.001) at 24 months, whereas intraretinal fluid showed a variable response, with a significant reduction observed at 3 months only (OR 0.204, 95% CI 0.05 to 0.79, p = 0.021). The proportion of eyes with a dry macula increased from 0% at baseline to 23.1% at 12 months and 24.0% at 24 months. Treatment intervals extended from 5.9 ± 1.2 weeks before switch to 8.7 ± 2.6 weeks at 12 months (p < 0.001) and 10.6 ± 3.0 weeks at 24 months (p < 0.001). No adverse events were observed.

Conclusion

Switching to faricimab was associated with improved anatomical outcomes and extended treatment intervals while maintaining stable visual acuity, suggesting benefits primarily related to anatomical control and reduced treatment burden.