Short-term real-world effectiveness of faricimab on macular edema due to retinal vein occlusion

Faricimab, the new anti-vascular endothelial growth factor (VEGF) drug including a bispecific antibody targeting both VEGF-A and angiopoietin-2 (Ang-2), has emerged as a therapeutic option for macular edema secondary to retinal vein occlusion (RVO), and its efficacy has been demonstrated in randomized controlled trials (RCTs); however, reports on its use in clinical practice are still limited. This study was conducted to evaluate the real-world treatment outcomes of faricimab for macular edema secondary to RVO, managed with a single initial injection plus pro re nata (1 + PRN) approach in both treatment-naïve and previously treated patients who switched to this regimen.

This retrospective observational study included patients diagnosed with branch or central RVO, who received intravitreal faricimab therapy following the 1 + PRN protocol. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were analyzed.

Thirty patients (17 naïve and 13 switched) were included. The number of IVF was 1.4 ± 0.7 and 2.4 ± 2.1, in the naïve and switch groups, respectively. The mean follow-up period was 3.7 ± 2.7 and 4.9 ± 2.9 months in the naïve and switch patients, respectively. Mean LogMAR BCVA improved in the naïve group from 0.30 ± 0.37 at baseline to 0.11 ± 0.20 (p = 0.01) at the final visit, while there was no significant difference between 0.45 ± 0.45 at baseline and 0.35 ± 0.37 at the final visit in the switch group (p = 0.19). CMT reduction was significant in both groups; from 442 ± 117 μm at baseline to 304 ± 57 μm at one month after final IVF (p < 0.0001) in the naïve group; and from 436 ± 170 μm at baseline to 285 ± 76 μm at one month after final IVF (p = 0.0002) in the switch group.

The 1 + PRN faricimab regimen improves vision and reduces macular edema with a reduced injection burden in patients with RVO. These findings validated the real-world efficacy of faricimab and supported its use as a viable therapeutic agent.