Borchert Grace A, Kiire Christine A, Stone Niamh M, Akil Handan, Gkika Theodora, Fischer M Dominik, Xue Kanmin, Cehajic-Kapetanovic Jasmina, MacLaren Robert E, Charbel Issa Peter, Downes Susan M, De Silva Samantha R
Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Oxford Eye Hospital, Oxford University NHS Foundation Trust, Oxford, UK.
Eye (Lond). 2024 Dec;38(18):3569-3577. doi: 10.1038/s41433-024-03364-y. Epub 2024 Oct 11.
Landmark studies reported on faricimab efficacy and safety predominantly in treatment naïve patients, but outcomes following switch from other anti-VEGF therapies are lacking. We evaluated patients switched to faricimab who had previously shown a partial response to other anti-VEGF injections for neovascular age-related macular degeneration (nAMD) and diabetic macular oedema (DMO).
Retrospective study at the Oxford Eye Hospital. Patients switched to faricimab from January to April 2023 with six months follow-up were identified via electronic medical records.
A total of 116 patients (151 eyes) were included. In 88 patients with nAMD (107 eyes), mean visual acuity remained stable: 62±17 ETDRS letters at baseline; 62±18 at six months (p > 0.05). Central subfield thickness (CST) reduced from 294 ± 73 μm to 270 ± 53 μm (p < 0.05) at six months. Subretinal or intraretinal fluid was present in 102 eyes (95%) at baseline and 75 eyes (70%) at follow-up (p < 0.05). Pigment epithelial detachment height decreased from 233 ± 134 μm to 188 ± 147 μm (p < 0.05). Mean treatment interval increased by 1.7 weeks (p < 0.05) and was extended in 61 eyes (57%) at six months. In 28 patients with DMO (44 eyes), visual acuity remained stable: 69 ± 15 letters at baseline; 70±15 at six months (p > 0.05). CST reduced from 355 ± 87 μm to 317 ± 82 μm (p < 0.05). Mean treatment interval increased by 1.4 weeks (p < 0.05) and was extended in 21 eyes (46%) by six months.
Switching to faricimab in treatment resistant eyes led to improved anatomical response and extended treatment interval in a significant proportion of patients. Ongoing review of real-world data will inform longer-term outcomes of safety and effectiveness.
里程碑式研究主要报道了法西单抗在初治患者中的疗效和安全性，但缺乏从其他抗血管内皮生长因子（VEGF）疗法转换后的结果。我们评估了转换为法西单抗治疗的患者，这些患者之前对其他用于治疗新生血管性年龄相关性黄斑变性（nAMD）和糖尿病性黄斑水肿（DMO）的抗VEGF注射剂有部分反应。
在牛津眼科医院进行的回顾性研究。通过电子病历识别出2023年1月至4月转换为法西单抗且有6个月随访期的患者。
共纳入116例患者（151只眼）。在88例nAMD患者（107只眼）中，平均视力保持稳定：基线时为62±17个早期糖尿病性视网膜病变研究（ETDRS）字母；6个月时为62±18个（p>0.05）。6个月时，中心子野厚度（CST）从294±73μm降至270±53μm（p<0.05）。基线时102只眼（95%）存在视网膜下或视网膜内液，随访时75只眼（70%）存在（p<0.05）。色素上皮脱离高度从233±134μm降至188±147μm（p<0.05）。平均治疗间隔延长了1.7周（p<0.05），6个月时61只眼（57%）延长。在28例DMO患者（44只眼）中，视力保持稳定：基线时为69±15个字母；6个月时为70±15个（p>0.05）。CST从355±87μm降至317±82μm（p<0.05）。平均治疗间隔延长了1.4周（p<0.05），6个月时21只眼（46%）延长。
在耐药眼中转换为法西单抗治疗可使相当一部分患者的解剖学反应得到改善，治疗间隔延长。对真实世界数据的持续审查将为安全性和有效性的长期结果提供信息。
