Real-world performance of faricimab for neovascular age-related macular degeneration and diabetic macular edema:...

BACKGROUND: To investigate real-world use of faricimab for the treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). METHODS: In this first analysis of the BrazilRetNet study group, we performed a multicenter, retrospective chart review of patients who completed the first three intravitreal injections of faricimab until October 2025; patients were followed in 15 retinal centers across Brazil. Collected data included clinical and demographic information, treatment strategy and history; main outcome measures were best-corrected visual acuity (BCVA) converted in ETDRS, macular central subfield thickness (CST) measured on optical coherence tomography (OCT), and adverse events. For comparison among baseline and follow-up variables, Wilcoxon test was employed; p values ≦ 0.05 were considered statistically significant. RESULTS: A total of 220 patients’ eyes were included. 145 eyes of 127 nAMD patients (56% women, average 78.6 ± 9.4 years-old, 94.5% caucasian) and 75 eyes of 54 DME patients (63% men, average 66.6 ± 10.9 years old, 83.3% caucasian). Prior intravitreal treatment was reported in 123 eyes (84.8%) with nAMD and 60 eyes (80%) with DME, with a mean of 16.8 and 11.7 previous injections, respectively. Baseline mean BCVA was 57.09 (nAMD) and 63.54 (DME). After three injections, mean BCVA improved to 61.06 for nAMD (p < 0.001; average gain of 3.97 letters) and 70.27 for DME (p < 0.001; average gain of 6.73 ETDRS letters). Baseline mean CST was 320.4 μm (nAMD) and 380.4 μm (DME), decreased to 264.3 μm (nAMD; p < 0.001; − 56.1 μm) and 312.7 μm (DME; p < 0.001; − 67.7 μm). Differences on BCVA and CST remained statistically significant when subgroups of naive or previously treated eyes were analyzed. All reported adverse events occurred in nAMD patients and included submacular hemorrhage (2 eyes), RPE tear (1 eye) and increased intraocular pressure (1 eye). No intraocular inflammation was reported. CONCLUSIONS: Overall, nAMD and DME patients treated with faricimab in this Brazilian cohort, presented BCVA improvement and a decreased CST after three injections. A low incidence of adverse events was reported, mostly associated to the natural history of the disease. Future analyses will provide further information on real-world farcimab treatment for nAMD and DME in Brazil.