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法西单抗治疗既往治疗过的新生血管性年龄相关性黄斑变性的1年真实世界疗效

1-Year real-world outcomes of faricimab in previously treated neovascular age-related macular degeneration.

作者信息

Janmohamed Imran Karim, Mushtaq Adeel, Kabbani Jamil, Harrow Simeon, Nadarajasundaram Aaruran, Ata Anibe, Monye Henrietta, Jarrar Zakariya, Hannan Shabeeba, Membrey Luke

机构信息

Maidstone Hospital Eye Department, Hermitage Lane, Maidstone, UK.

Queen Elizabeth Hospital, Woolwich, London, UK.

出版信息

Eye (Lond). 2025 May;39(7):1344-1348. doi: 10.1038/s41433-025-03616-5. Epub 2025 Jan 25.

Abstract

BACKGROUND AND OBJECTIVES

Faricimab, a bispecific antibody targeting VEGF-A and angiopoietin-2, has shown promise in treating neovascular age-related macular degeneration (nAMD). This study evaluates 1-year outcomes of faricimab in treatment-experienced nAMD patients.

METHODS

This single-centre retrospective cohort study included patients previously treated for nAMD who switched to faricimab between November 2022 and March 2024. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and treatment intervals were assessed at baseline, 6, and 12 months.

RESULTS

One hundred eighty-four patients (215 eyes) were included. Patients had received a median of 18 (interquartile range [IQR] 10-28.5) anti-VEGF injections per eye over an average of 5.02 ± 11.82 years before switch. An average of 8.63 ± 2.2 faricimab injections were administered per eye over an average follow-up of 12.19 ± 2.70 months. Median BCVA decreased from 70 ETDRS letters (IQR 55-76) at baseline to 62 (IQR 47-76) at 12 months (p = 0.0038). Median CMT improved from 259.5 μm (IQR 223-299.75) at baseline to 232 μm (202.0-272.5) at 12 months (p < 0.0001). At the last follow-up, 40.2% of eyes were dry on OCT. The median dosing interval doubled from 4 weeks (IQR 4-4) to 8 weeks (IQR 6-10) with faricimab (p < 0.0001). 47.4% and 16.3% of eyes achieved treatment intervals of ≥8-12 weeks and ≥12 weeks, respectively. Three events of uveitis were noted following the loading phase.

CONCLUSIONS

This real-world study demonstrates that faricimab maintains vision and achieves significant anatomical improvements in treatment-experienced nAMD patients. The extended treatment intervals could significantly reduce the burden on patients and healthcare resources.

摘要

背景与目的

法西单抗是一种靶向血管内皮生长因子A(VEGF-A)和血管生成素-2的双特异性抗体,在治疗新生血管性年龄相关性黄斑变性(nAMD)方面显示出前景。本研究评估了法西单抗在有治疗经验的nAMD患者中的1年疗效。

方法

这项单中心回顾性队列研究纳入了曾接受nAMD治疗、于2022年11月至2024年3月期间改用 法西单抗的患者。在基线、6个月和12个月时评估最佳矫正视力(BCVA)、中心黄斑厚度(CMT)和治疗间隔。

结果

共纳入184例患者(215只眼)。在改用药物前,患者每只眼平均接受了5.02±11.82年的抗VEGF注射,中位数为18次(四分位间距[IQR]10-28.5)。在平均12.19±2.70个月的随访期间,每只眼平均接受了8.63±2.2次法西单抗注射。BCVA中位数从基线时的70个ETDRS字母(IQR 55-76)降至12个月时的62个(IQR 47-76)(p=0.0038)。CMT中位数从基线时的259.5μm(IQR 223-299.75)改善至12个月时的232μm(202.0-272.5)(p<0.0001)。在最后一次随访时,40.2%的眼在光学相干断层扫描(OCT)上显示为干性。使用法西单抗时,给药间隔中位数从4周(IQR 4-4)增加一倍至8周(IQR 6-10)(p<0.0001)。47.4%和16.3%的眼分别实现了≥8-12周和≥12周的治疗间隔。在负荷期后记录到3例葡萄膜炎事件。

结论

这项真实世界研究表明,法西单抗在有治疗经验的nAMD患者中可维持视力并实现显著的解剖学改善。延长的治疗间隔可显著减轻患者和医疗资源的负担。

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