Short-Term Improvements Seen in Patients With nAMD Switching to Faricimab

Switching from other anti-vascular endothelial growth factor (VEGF) therapies to faricimab in patients with neovascular age-related macular degeneration (nAMD) was found to induce short-term improvements in several visual and anatomical outcomes, according to a study published in Medicine.¹

The leading cause of visual impairment in older adults is nAMD, which is characterized by abnormal vascular growth and fluid buildup, which can sometimes lead to the formation of pigment epithelial detachment (PED).^2,3 Anti-VEGF treatment is the primary method of addressing nAMD, but some patients are resistant to the traditional forms of anti-VEGF. Faricimab offers an alternative method of treatment for nAMD. This study aimed to assess the efficacy of faricimab, specifically as it pertains to visual and anatomic outcomes, in patients living in China.

The study was conducted at the Department of Ophthalmology in the Third People’s Hospital of Dalian, China, between March and July of 2024. All participants had nAMD and switched from another anti-VEGF treatment to faricimab. Participants were included if they had macular neovascularization secondary to nAMD, had switched to faricimab, had evidence of recurrent fluid after being treated with another anti-VEGF, and had completed an observation period of 1 month after switching. Participants that had a history of photodynamic therapy, polypoidal choroidal vasculopathy, retinal or optic nerve disease, or who had inflammatory or hereditary diseases were excluded from the study.

Switching to faricimab was effective in patients who did not have success with other anti-VEGF therapies | Image credit: RFBSIP - stock.adobe.com

Participants received their dose of faricimab at baseline and after 30 days. Best corrected visual acuity (BCVA) was assessed in all participants along with subretinal fluid (SRF) and intraretinal fluid (IRF). Optical coherence tomography was taken as well.

There were 35 eyes from 35 patients that were included in this study. The mean (SD) age was 69.74 (11.22) years, and 12 of the participants were women. Other forms of anti-VEGF were received a mean of 6.27 (3.41) times through injections, with 12 receiving aflibercept, 14 receiving ranibizumab, and 9 receiving conbercept.

The researchers found that mean BCVA improved from 0.38 (0.12) to 0.29 (0.25) after 1 month, but it was not statistically significant. Central macular thickness decreased from 511.78 (110.29) to 351.48 (101.23) from baseline to follow-up. The height (331.56 [112.23] to 209.65 [89.45]) and volume (2137.11 [966.23] to 1473.23 [754.12]) of PED both decreased from baseline to follow-up.

A total of 20 eyes (57.14%) had SRF at baseline compared with 11 eyes (31.42%) after 1 month; similarly, a total of 16 eyes (45.71%) had IRF at baseline compared with 8 eyes (22.85%) after 1 month. PED incidence was reduced from 60% to 45.71% after treatment.

The authors noted several limitations of the study. The design of the study did not allow for more comparisons between faricimab and other anti-VEGF therapies, and selection and investigator bias are possible due to the small sample size derived from a single center. The study also had a short follow-up time that will need to be further investigated. The study relied on short-term data to draw conclusions. Clinical outcomes were not measured, and objective data were not used due to the design of the study. A control group was also not used.

Still, anatomical benefits were seen for patients that switched to faricimab from other anti-VEGF therapies. “Further research with a larger sample size, extended observation periods, and standardized injection regimens is necessary to identify the optimal switching strategy from anti-VEGF in routine clinical practice,” the authors concluded.

References

1. Liu D, Li C, Cui L, Li S. Short-term comparison of switching to faricimab from other anti-VEGF agents in neovascular age-related macular degeneration patients: a retrospective study. Medicine. 2025;104:17. doi:10.1097/MD0000000000042002
2. Stages of AMD. Macular Disease Foundation Australia. Accessed April 29, 2025. https://www.mdfoundation.com.au/about-macular-disease/age-related-macular-degeneration/stages-of-amd/
3. Pigment epithelial detachment. American Academy of Ophthalmology. August 13, 2024. Accessed April 29, 2025. https://eyewiki.org/Pigment_Epithelial_Detachment