Visual Acuity and Durability Outcomes of Faricimab Compared With Other Anti-vascular Endothelial Growth Factor Agents Within Routine Clinical Practice for Diabetic Macular Edema

Abstract

Purpose: This study assessed visual outcomes and dosing frequencies of faricimab compared with other antivascular endothelial growth factor agents in treatment-naïve and treatment-experienced eyes with diabetic macular edema. Methods: The de-identified electronic medical records of patients with diabetic macular edema in the Vestrum Health database between January 2021 and December 2023 were analyzed, including eyes treated with faricimab, bevacizumab, ranibizumab, and aflibercept. Through 6 injections for treatment-naïve eyes and 2 injections for treatment-experienced eyes, we recorded changes in mean visual acuity (VA) and mean number of days between injections. Results: By injection 6, a total of 14 103 treatment-naïve eyes receiving faricimab (n = 167), bevacizumab (n = 7529), ranibizumab (n = 1433), and aflibercept (n = 4947) gained 4.6, 7.3, 7.1, and 6.7 letters, respectively. After stratifying by baseline VA, mean VA change in faricimab-treated eyes was statistically similar to that of eyes treated with other agents. After 2 injections, in 1 378 eyes switched to faricimab from aflibercept, bevacizumab, and ranibizumab, mean letters gained were 0.8, 0.8, and 3.1, respectively. Eyes switched to faricimab improved similarly to those switched to aflibercept and ranibizumab, but had worse outcomes than eyes switched to bevacizumab (P < .01). The percentage of treatment-naïve eyes treated with faricimab that reached 50 or more mean days between injections 5 and 6 was significantly greater than eyes treated with bevacizumab and ranibizumab (P < .01 for both). Conclusions: VA outcomes for treatment-naïve eyes receiving faricimab were similar to those of other eyes after adjustment for baseline VA. Furthermore, our findings suggest that faricimab may offer better durability outcomes than other antivascular endothelial growth factor agents.

Keywords

diabetic macular edema faricimab intravitreal anti-VEGF injections visual outcomes large database analysis

Get full access to this article

View all access options for this article.

References

Yau

JWY

Rogers

Kawasaki

, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556-564. doi:10.2337/dc11-1909

Varma

Bressler

Doan

, et al. Prevalence of and risk factors for diabetic macular edema in the United States. JAMA Ophthalmol. 2014;132(11):1334-1340. doi:10.1001/jamaophthalmol.2014.2854

Simó

Sundstrom

Antonetti

DA.

Ocular Anti-VEGF therapy for diabetic retinopathy: the role of VEGF in the pathogenesis of diabetic retinopathy. Diabetes Care. 2014;37(4):893-899. doi:10.2337/dc13-2002

Chauhan

Rather

Samarah

Elhusseiny

Sallam

AB.

Current and novel therapeutic approaches for treatment of diabetic macular edema. Cells. 2022;11(12):1950. doi:10.3390/cells11121950

Canonica

Foxton

Garrido

, et al. Delineating effects of angiopoietin-2 inhibition on vascular permeability and inflammation in models of retinal neovascularization and ischemia/reperfusion. Front Cell Neurosci. 2023;17:1192464. doi:10.3389/fncel.2023.1192464

Wykoff

Abreu

Adamis

, et al. Efficacy, durability, and safety of intravitreal faricimab with extended dosing up to every 16 weeks in patients with diabetic macular oedema (YOSEMITE and RHINE): two randomised, double-masked, phase 3 trials. Lancet. 2022;399(10326):741-755. doi:10.1016/S0140-6736(22)00018-6

Nielsen

Kahn

Aziz

, et al. Real world efficacy, durability and safety of faricimab in diabetic macular edema: the TAHOE Study. Paper presented at: EURETINA Annual Meeting; Amsterdam; 2023.

Borkar

Tabano

Garmo

, et al. Early treatment patterns and outcomes in patients with diabetic macular edema treated with faricimab: the FARETINA-DME study. Paper presented at: American Society of Retinal Specialists Annual Meeting; Seattle; 2023.

Bailey

Tabano

Borkar

, et al. FARETINA-DME- six-month treatment patterns and outcomes in patients with diabetic macular edema treated with faricimab: an IRIS registry analysis. Paper presented at: EURETINA Annual Meeting; Amsterdam; 2023.

10.

Bailey

Peto

Downey

, et al. FARWIDE-DME: early treatment patterns of faricimab among DME patients in the UK. Paper presented at: EURETINA Annual Meeting; Amsterdam; 2023.

11.

Gregori

Feuer

Rosenfeld

PJ.

Novel method for analyzing snellen visual acuity measurements. Retina. 2010;30(7):1046. doi:10.1097/IAE.0b013e3181d87e04

12.

Maturi

Scott

Carson

Ciulla

Maturi

Effect of race and insurance status on treatment and outcomes in diabetic retinopathy: analysis of 43 274 eyes using the IRIS registry. J Vitreoretin Dis. 2024;8(3):270-279. doi:10.1177/24741264231221607

13.

Malhotra

Greenlee

Iyer

Conti

Chen

Singh

RP.

Racial, ethnic, and insurance-based disparities upon initiation of anti-vascular endothelial growth factor therapy for diabetic macular edema in the US. Ophthalmology. 2021;128(10):1438-1447. doi:10.1016/j.ophtha.2021.03.010

14.

Ciulla

Hussain

Pollack

Williams

DF.

Visual acuity outcomes and anti-vascular endothelial growth factor therapy intensity in neovascular age-related macular degeneration patients: a real-world analysis of 49 485 eyes. Ophthalmol Retina. 2020;4(1):19-30. doi:10.1016/j.oret.2019.05.017

15.

Ciulla

Pollack

Williams

DF.

Visual acuity outcomes and anti-VEGF therapy intensity in diabetic macular oedema: a real-world analysis of 28 658 patient eyes. Br J Ophthalmol. 2021;105(2):216-221. doi:10.1136/bjophthalmol-2020-315933

16.

Ferris

Maguire

Glassman

Ying

Martin

DF.

Evaluating effects of switching anti-vascular endothelial growth factor drugs for age-related macular degeneration and diabetic macular edema. JAMA Ophthalmol. 2017;135(2):145-149. doi:10.1001/jamaophthalmol.2016.4820

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB