Wolfrum Peter, Böhm Elsa Wilma, Lorenz Katrin, Stoffelns Bernhard, Pfeiffer Norbert, Korb Christina A
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
J Clin Med. 2025 Jan 10;14(2):423. doi: 10.3390/jcm14020423.
In this study, we evaluated clinical outcomes following a therapy switch to Faricimab, in a patient cohort affected by neovascular age-related macular degeneration (nAMD), having received prior intravitreal anti-VEGF therapy. A retrospective investigation, including 28 eyes of 23 patients, treated for nAMD at the University Medical Center Mainz, Germany was performed. A switch in therapy to Faricimab was conducted, due to an inadequate response to the previous anti-VEGF treatment. Visual acuity (VA), central retinal thickness (CRT), and axial pigment epithelial detachment (PED) height were analyzed, following the first (FU 1) and second (FU 2) Faricimab injection series. Further, a subgroup analysis was conducted to compare Faricimab responders and diminished responders, as well as an exploratory data analyses to evaluate potential influencing factors on VA and CRT changes. The mean age of patients was 82 years, with an average prior anti-VEGF treatment duration of 4.4 years and an average of 33 prior injections. Following Faricimab, at FU 1, significant reductions in CRT (from 335.8 µm to 260.0 µm, < 0.01) and axial PED height (from 177 µm to 116 µm, < 0.01) were observed. At FU 2, anatomical improvements were stable. No significant improvements in VA were observed, with LogMAR remaining stable at FU 1 and FU 2. In the subgroup comparison, eight eyes fulfilled the responder criteria, exhibiting morphological and functional improvements following intravitreal Faricimab. Further, a bigger baseline CRT correlated with a bigger post-treatment CRT and a longer prior treatment duration, and a worse baseline VA correlated with a worse post-Faricimab VA. No adverse events were noted following the switch to Faricimab. Following a switch to Faricimab, significant anatomical improvements were observed, while VA remained stable. Baseline CRT, prior treatment duration, and baseline LogMAR were associated with clinical outcomes post the switch to Faricimab. Further investigations into long-term outcomes are necessary to evaluate the sustained efficacy of Faricimab.
在本研究中，我们评估了在接受过玻璃体内抗血管内皮生长因子（VEGF）治疗的新生血管性年龄相关性黄斑变性（nAMD）患者队列中，改用法西单抗治疗后的临床结局。我们对德国美因茨大学医学中心治疗nAMD的23例患者的28只眼进行了一项回顾性调查。由于对先前的抗VEGF治疗反应不足，因此改用了法西单抗治疗。在首次（FU 1）和第二次（FU 2）法西单抗注射系列后，分析了视力（VA）、中心视网膜厚度（CRT）和轴向色素上皮脱离（PED）高度。此外，进行了亚组分析，以比较法西单抗反应者和反应减弱者，并进行探索性数据分析，以评估对VA和CRT变化的潜在影响因素。患者的平均年龄为82岁，先前抗VEGF治疗的平均持续时间为4.4年，平均先前注射次数为33次。在法西单抗治疗后，在FU 1时，观察到CRT（从335.8 µm降至260.0 µm，<0.01）和轴向PED高度（从177 µm降至116 µm，<0.01）显著降低。在FU 2时，解剖学改善情况稳定。未观察到VA有显著改善，LogMAR在FU 1和FU 2时保持稳定。在亚组比较中，8只眼符合反应者标准，玻璃体内注射法西单抗后表现出形态和功能改善。此外，基线CRT越大，治疗后CRT越大，先前治疗持续时间越长，基线VA越差，法西单抗治疗后的VA越差。改用法西单抗后未观察到不良事件。改用法西单抗后，观察到显著的解剖学改善，而VA保持稳定。基线CRT、先前治疗持续时间和基线LogMAR与改用法西单抗后的临床结局相关。有必要对长期结局进行进一步研究，以评估法西单抗的持续疗效。
