Faricimab appears comparable to ranibizumab through 52 weeks
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For more than a decade, intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy has been the first line in treating neovascular age-related macular degeneration (nAMD). However, patients require frequent anti-VEGF injections to maintain visual outcomes. Real-world outcome studies show that patients in clinical practice receive fewer injections than patients in randomized clinical trials, correlating with significant vision loss over time. phase 2 trial assessed extended dosing of faricimab compared with monthly ranibizumab for neovascular AMD.

Researchers conducted a randomized, multicenter, active comparator-controlled, parallel-group study over a 52-week period. Seventy-six patients were randomized 2:2:1 to receive either a 6-mg dose of faricimab every 16 or 12 weeks or a 0.5-mg dose of ranibizumab every 4 weeks; the faricimab arms initially received 4 monthly doses. A disease activity assessment was performed at week 24. The primary endpoint was mean change in BCVA at week 40.

At week 24, 65% (36/55) of patients in the faricimab arms showed no disease activity. By week 40, the patients in the 2 faricimab groups achieved comparable visual acuity gains to the ranibizumab arm. Spectral-domain OCT and fluorescein angiography at weeks 40 and 52 revealed comparable reductions in central subfield thickness and lesion size in all 3 groups. There were no new or unexpected safety events during the trial.

Clinical significance
Faricimab has the potential to address an unmet need and reduce the treatment burden among patients who show a decline in the number of AMD treatment injections over time in the real world. Phase 3 trials are ongoing to further evaluate the efficacy, durability, and safety of faricimab.

Source:https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2768857, AAO