Therapeutic effects of faricimab on aflibercept-refractory age-related macular degeneration

Sci Rep. 2023 Nov 30;13(1):21128. doi: 10.1038/s41598-023-48190-6.

Abstract

Though vascular endothelial growth factors (VEGF) and other proangiogenic factors, such as angiopoietins (Ang), may be involved in the development of neovascular age-related macular degeneration (nvAMD), only drugs that inhibit the VEGF family are available for the treatment. The newly approved anti-VEGF drug faricimab, which also inhibits Ang-2, is expected to be effective in patients with AMD refractory to conventional anti-VEGF drugs. Therefore, we prospectively investigated the efficacy of faricimab in the treatment of aflibercept-refractory nvAMD. Patients with nvAMD who had been treated with aflibercept in the last year and required bimonthly injections were recruited. 25 eyes showed persistent exudative changes immediately before the faricimab injection (baseline). In these 25 eyes, switching to faricimab did not change visual acuity or central retinal thickness 2 months after the injection; however, 56% of eyes showed reduction or complete absorption of fluid. Notably, 25% of the eyes that showed dry macula at month 2 had no fluid recurrence for up to 4 months. These results indicate that faricimab could benefit some patients with aflibercept-refractory nvAMD.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Macular Degeneration* / drug therapy
  • Ranibizumab
  • Receptors, Vascular Endothelial Growth Factor / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A
  • Wet Macular Degeneration* / drug therapy

Substances

  • aflibercept
  • Ranibizumab
  • Vascular Endothelial Growth Factor A
  • faricimab
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins
  • Angiogenesis Inhibitors