Faricimab in Treatment-Naïve nAMD: Regional UK Real-World Experience

Neovascular age-related macular degeneration (nAMD) is a progressive retinal disease leading to significant vision loss. Previous standard of care, anti-vascular endothelial growth factor (anti-VEGF) monotherapy, requires frequent injections to maintain efficacy. Faricimab, which targets angiopoietin-2 and VEGF-A, has shown efficacy in patients with nAMD with extended dosing intervals in randomised controlled trials (RCTs). However, results from RCTs are often challenging to replicate in real-world practice. This study aimed to explore outcomes in patients with nAMD treated with faricimab in real-world settings in the UK.

Newly diagnosed patients with nAMD receiving first-line faricimab between 2022 and 2024 were examined across six UK sites in England and Wales. Patients were generally treated per the National Institute of Health and Care Excellence (NICE)-recommended protocol for approximately 1 year, with some deviations at individual sites. Outcomes reported included best-corrected visual acuity (BCVA), optical coherence tomography (OCT) fluid, retinal thickness, treatment intervals and safety. Data were analysed separately for each site; adverse event incidence was pooled.

The total number of eyes treated was 505 from 473 patients. Baseline characteristics were similar across sites, with a mean age of 77.0-82.0 years. BCVA, OCT fluid and retinal thickness improvements from baseline were observed across all sites, irrespective of timepoint or treatment protocol. BCVA improvements from baseline ranged from + 5.1 to + 7.7 letters at the first post-loading visit and from + 5.0 to + 8.2 letters at 12 months. Mean change in retinal thickness from baseline ranged from - 92.3 to - 127.7 μm at 12 months. Most patients received faricimab at intervals of ≥ 8 weeks following the loading phase. The pooled incidence of adverse events was low.

Faricimab demonstrated consistent visual and anatomical improvements in real-world UK settings across a heterogeneous group of patients with nAMD. Further real-world studies will be essential to confirm long-term safety and effectiveness in clinical practice.