Faricimab Brought Early Control of Some Symptoms in AMD

Patients with age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV) who had not been treated previously were found to have better control of pigment epithelial detachment (PED), subretinal hyperreflective material (SHRM), and hyperreflective foci (HRF) when using faricimab vs aflibercept.¹

AMD and PCV are both leading causes of vision impairment overall, with aflibercept being a common antivascular endothelial growth factor (VEGF) that is used to treat the conditions. Faricimab has also come into use as a bispecific antibody that targets both VEGF and angiopoietin-2.² Faricimab has been shown to be equally effective in treating AMD in the past,³ but short-term gains are not usually the focus. This study aimed to compare early outcomes between intravitreal faricimab vs aflibercept in patients with neovascular AMD (nAMD) or PCV who had not been treated in the past.

The study took place in a medical center in Taipei between August 2023 and August 2024. Adults with treatment-naïve nAMD or PCV were included if they took 3 monthly intravitreal injections of either 2.0 mg/0.05 mL aflibercept or 6.0 mg/0.05 mL faricimab. Patients were treated with aflibercept before 2023 and faricimab after. Optical coherence tomography (OCT) and fluorescein angiography were given to all patients; nAMD and PCV were diagnosed by a specialist.

Change in best-corrected visual acuity (BCVA) was the primary outcome of the study, with measurements coming at baseline and after 1, 2, 3, and 4 months. Central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) acted as the secondary outcomes.

There were 38 patients with nAMD or PCV who were included in the study who received faricimab. These patients were matched with patients who had received aflibercept. No significant differences in demographics were found between the 2 groups, and baseline visual acuity was comparable.

The faricimab group had significant improvements in BCVA through 4 months, improving from a mean (SD) BCVA of 0.78 (0.47) at baseline to 0.66 (0.65) after 4 months, compared with aflibercept, where the baseline BCVA was 0.78 (0.41) and the BCVA after 4 months was 0.72 (0.60), which was not significant. The difference in BCVA after 4 months was not significant. Mean CMT was reduced in both groups, going from 322.3 (95.6) μm to 239.9 (64.8) μm in the faricimab group and 339.5 (99.8) μm to 227.5 (49.6) μm in the aflibercept group. The difference between the 2 groups was not significant.

The faricimab group had a lower number of patients with persistent PED, fewer patients had SHRM at 3 and 4 months of treatment, and fewer patients had HRF after 3 or 4 months of treatment when compared with those who took aflibercept.

There were some limitations to this study. Long-term outcomes could not be evaluated due to the short time period. The generalizability could be limited due to all patients in this study being from Taiwan. This was a retrospective study, and all patients were not treated with these forms of treatment at the same time. The statistical power may be limited due to the small sample size. Bias is possible due to the single-center design. Future analyses will need to be done to account for future developments.

Although faricimab and aflibercept both improved BCVA, the authors concluded that their “4-month observational analysis showed that faricimab may offer greater control of PED, SHRM, and HRF, probably due to the dual targets of faricimab.” Long-term studies will need to be done to confirm these findings.

References

1. Yang CC, Weng CC, Chou YB, et al. Early anatomical outcomes of faricimab vs aflibercept 2 mg in treatment-naïve neovascular AMD and PCV: a head-to-head comparative study in Taiwan. J Chin Med Assoc. Published online November 24, 2025. doi:10.1097/JCMA.0000000000001320

2. Faricimab. EyeWiki. Updated March 23, 2025. Accessed November 24, 2025. https://eyewiki.org/Faricimab

3. Liberski S, Wichrowska M, Kocięcki J. Aflibercept versus faricimab in the treatment of neovascular age-related macular degeneration and diabetic macular edema: a review. Int J Mol Sci. 2022;23(16):9424. doi:10.3390/ijms23169424