Extension of the intravitreal injection interval after switching to faricimab in patients with exudative AMD: The...

To assess whether switching to faricimab allowed extending injection intervals without exudation in patients with neovascular age-related macular degeneration (nAMD) and to identify predictive factors for interval extension.

FAR WEST was a multicenter, observational retrospective cohort study, including patients with nAMD treated with intravitreal anti-VEGF injections (IVI) for at least one year prior to switching to faricimab. Data were collected from the medical records at the time of the decision to switch to faricimab (M0) and at the M6 follow-up visit. The switch strategy (whether an induction phase was performed or not) was left to the practitioner's discretion.

A total of 814 eyes of 705 patients were included in 23 centers. The recurrence-free IVI interval increased significantly from 5.6 weeks at M0 to 7.2 weeks at M6 (+1.6 weeks, P<0.0001). The proportion of exudative patients decreased by 37% (P<0.0001). Among 228 refractory cases at M0, 88 (39%) achieved a dry macula at M6. A greater interval extension was found in patients who underwent immediate extension. No significant differences were observed in terms of age, time since first injection, type of neovascularisation, or pre-switch IVI interval. The intraocular inflammation rate was 0.6% (n=5).

Switching to faricimab allowed for significantly extending the recurrence-free IVI interval and decreasing the proportion of exudative patients in this cohort. Significant extension was found in a wide range of patients, including those without a loading phase. Further controlled prospective studies are needed to assess the value of a loading phase when switching to faricimab. Safety outcomes were consistent with prior studies.