Early Anatomical and Functional Outcomes of Faricimab in Recalcitrant Neovascular Age-Related Macular Degeneration: A Retrospective Real-World Study in an East-Asian Population.

INTRODUCTION

Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss, with some eyes showing recalcitrant disease despite standard anti-vascular endothelial growth factor (anti-VEGF) therapy. While clinical trials have demonstrated promising efficacy and safety of faricimab in treatment-naïve patients, only 9% of participants were Asian, and real-world data on its effectiveness in pretreated Asian populations remain limited. This study aims to evaluate the efficacy and longitudinal response of intravitreal faricimab in patients with recalcitrant nAMD in Taiwan by analyzing visual acuity, anatomical outcomes, and treatment interval extension over a 6-month period.

METHODS

This was a retrospective observational study at National Taiwan University Hospital. Patients switched to intravitreal faricimab (6 mg/0.05 mL; Vabysmo™) from July 2023 to May 2024 with 6 months follow-up identified via electronic medical records. Injections were administered without a loading phase. Retreatment was guided by the presence of retinal fluid on optical coherence tomography (OCT), with or without visual decline.

RESULTS

A total of 33 eyes from 28 patients were analyzed. Visual acuity remained stable over 6 months (p = 0.147). Central retinal thickness significantly improved from 267 to 235 μm at 3 months (p = 0.002) and remained stable at 6 months (p = 0.003). Subretinal fluid resolved in 36.4% of eyes at 3 months (p < 0.001) and 48.5% at 6 months (p = 0.002), while changes in intraretinal fluid (IRF) and pigment epithelial detachment (PED) height were not significant. Treatment intervals were extended in 52% of eyes, with 56% reaching ≥ 16 weeks (Q16W) intervals. No serious ocular or systemic adverse events were reported.

CONCLUSIONS

Intravitreal faricimab demonstrated improved anatomical outcomes with stable visual acuity and extended treatment intervals in patients with recalcitrant nAMD in Taiwan, addressing a key evidence gap. Future studies with longer follow-ups are needed to validate these findings.