Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, Japan.
Department of Ophthalmology, Fukushima Medical University, Fukushima, Japan.
Graefes Arch Clin Exp Ophthalmol. 2024 Jan;262(1):43-51. doi: 10.1007/s00417-023-06222-x. Epub 2023 Sep 5.
To assess 6-month outcomes of switching from aflibercept to faricimab in eyes with refractory neovascular age-related macular degeneration (nAMD) previously requiring monthly injections.
This multicenter retrospective study examined nAMD eyes receiving monthly aflibercept injections switched to faricimab administered monthly up to 4 injections followed by injections at a minimum of 2-month intervals as per drug labeling. Data regarding age, sex, number of previous injections, treatment intervals, and best-corrected visual acuity (BCVA) were collected. Central retinal thickness (CRT), subfoveal choroidal thickness (SFCT), and maximal pigment epithelial detachment (PED) height were measured by optical coherence tomography.
The study included 130 eyes of 124 patients. At 6 months, 53 eyes (40.8%) continued on faricimab treatment (Group 1), while 77 eyes (59.2%) discontinued faricimab for various reasons (Group 2) the most common being worse exudation. There were no significant differences between the two groups at baseline. In Group 1, CRT and SFCT significantly decreased at 1 month (P = 0.013 and 0.008), although statistical significance was lost at 6 months (P = 0.689 and 0.052). BCVA and maximal PED height showed no significant changes; however, mean treatment intervals were extended from 4.4 ± 0.5 weeks at baseline to 8.7 ± 1.7 weeks at 6 months (P < 0.001) in Group 1. No clear predictors of response were identified.
Switching from aflibercept to faricimab allowed for extension of treatment intervals from monthly to bimonthly in roughly 40% of eyes, suggesting that faricimab may be considered in refractory nAMD cases.
评估先前每月注射阿柏西普的难治性新生血管性年龄相关性黄斑变性（nAMD）患者改用 faricimab 的 6 个月结果。
这项多中心回顾性研究检查了每月接受 aflibercept 注射的 nAMD 眼，转为根据药物标签每月最多注射 4 次，然后至少每 2 个月注射一次。收集了年龄、性别、先前注射次数、治疗间隔和最佳矫正视力（BCVA）的数据。通过光学相干断层扫描测量中心视网膜厚度（CRT）、中心下脉络膜厚度（SFCT）和最大色素上皮脱离（PED）高度。
该研究纳入了 124 名患者的 130 只眼。6 个月时，53 只眼（40.8%）继续接受 faricimab 治疗（组 1），77 只眼（59.2%）因各种原因停用 faricimab（组 2），最常见的原因是渗出加重。两组在基线时无显著差异。在组 1 中，CRT 和 SFCT 在 1 个月时显著降低（P = 0.013 和 0.008），尽管在 6 个月时失去了统计学意义（P = 0.689 和 0.052）。BCVA 和最大 PED 高度无显著变化；然而，在组 1 中，平均治疗间隔从基线时的 4.4 ± 0.5 周延长至 6 个月时的 8.7 ± 1.7 周（P < 0.001）。未确定明确的反应预测因素。
从 aflibercept 转换为 faricimab 可使大约 40%的患者的治疗间隔从每月延长至每两个月，表明在难治性 nAMD 病例中可以考虑使用 faricimab。
