Cleveland Clinic Abu Dhabi, Eye Institute, Al Maryah Island, PO Box 112412, Abu Dhabi, United Arab Emirates.
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Int Ophthalmol. 2024 Sep 5;44(1):369. doi: 10.1007/s10792-024-03297-1.
To investigate the efficacy and outcomes of switching neovascular age-related macular degeneration (nAMD) patients from aflibercept to faricimab, focusing on visual acuity, retinal fluid management, and treatment intervals. The primary aim was to assess the early outcomes in nAMD patients refractory to aflibercept and explore faricimab's potential as a longer-lasting therapeutic alternative.
A single-center retrospective study was conducted on 50 refractory nAMD patients at Cleveland Clinic Abu Dhabi from September 2022-May 2023. Patients were switched from aflibercept to faricimab, having met specific criteria for refractory nAMD. The study analyzed best-corrected visual acuity (BCVA), central subfield thickness (CST), and fluid changes post-switch, using Optical Coherence Tomography (OCT).
After three faricimab injections, significant reductions in CST were observed, with a notable decrease in retinal fluid. The mean BCVA remained stable throughout the study period. Although there was a decrease in the maximum pigment epithelial detachment (PED) height, it was not statistically significant. Treatment intervals post-switch showed that the majority of patients maintained or extended their treatment intervals, with a significant proportion achieving resolution of intraretinal fluid (IRF) and subretinal fluid (SRF).
Switching to faricimab from aflibercept in refractory nAMD patients led to significant improvements in retinal fluid management and CST, with stable BCVA outcomes. Faricimab presents a promising alternative for patients requiring frequent aflibercept injections, potentially offering a more manageable treatment regimen with extended dosing intervals. This study highlights the need for personalized therapeutic strategies in nAMD treatment, though further research is necessary to optimize treatment switches.
探讨将新生血管性年龄相关性黄斑变性（nAMD）患者从阿柏西普转换为 faricimab 的疗效和结果，重点关注视力、视网膜液管理和治疗间隔。主要目的是评估对阿柏西普治疗无反应的 nAMD 患者的早期结果，并探讨 faricimab 作为一种更持久治疗选择的潜力。
对 2022 年 9 月至 2023 年 5 月在阿布扎比克利夫兰诊所的 50 名难治性 nAMD 患者进行了一项单中心回顾性研究。这些患者符合难治性 nAMD 的特定标准，已从阿柏西普转换为 faricimab。该研究通过光学相干断层扫描（OCT）分析了转换后的最佳矫正视力（BCVA）、中央子场厚度（CST）和液体变化。
在接受三次 faricimab 注射后，CST 显著降低，视网膜液显著减少。整个研究期间，平均 BCVA 保持稳定。尽管最大色素上皮脱离（PED）高度有所下降，但无统计学意义。转换后的治疗间隔表明，大多数患者保持或延长了治疗间隔，很大一部分患者实现了视网膜内液（IRF）和视网膜下液（SRF）的消退。
在难治性 nAMD 患者中，从阿柏西普转换为 faricimab 可显著改善视网膜液管理和 CST，同时保持 BCVA 结果稳定。faricimab 为需要频繁注射阿柏西普的患者提供了一种有前途的替代方案，可能提供更易于管理的治疗方案，延长了给药间隔。本研究强调了在 nAMD 治疗中需要个体化治疗策略，但需要进一步研究以优化治疗转换。
