Dosing interval optimization and persistence with faricimab in age-related macular degeneration: An observational study in real-world clinical practice

To evaluate treatment persistence and dosing interval extension with faricimab in neovascular age-related macular degeneration (nAMD) in real-world practice. Retrospective observational study conducted in a tertiary hospital (March 2024–March 2025). Patients receiving faricimab (treatment-naïve or pre-treated with anti-VEGF therapy), with ≥ 1 post-loading dose, were included. Dosing intervals were analyzed at baseline, 6 and 12 months, Adherence was assessed with the medication possession ratio (MPR), with > 80% considered adherent. Persistence was defined as the time from treatment initiation to discontinuation or end of follow-up. Persistence was estimated using Kaplan–Meier survival analysis. We included 129 patients (148 eyes), mean age 74.5 ± 8.85 years; 55% were female. A total of 39 patients (30.2%) were treatment-naïve and 90 (69.8%) were pretreated. At 12 months, 48.8% of naïve and 55.5% of pretreated patients achieved 8–12 weeks intervals. Mean persistence was 12.2 months (SD 0.2; 95% CI: 11.8–12.6). The median was not reached by the end of the study. Persistence rate was 93% at 6 and 12 months. Only one patient discontinued due to inefficacy. No serious adverse events or endophthalmitis occurred. Faricimab showed excellent persistence and extended dosing intervals in real-world practice. This is the first study specifically evaluating faricimab real-world persistence in nAMD. Evaluar persistencia e intervalo de administración de faricimab en la degeneración macular asociada a la edad neovascular (DMAEn) en práctica clínica real. Estudio observacional retrospectivo. Se incluyeron pacientes pretratados y no pretratados con anti-VEGF que recibieron faricimab entre marzo 2024–2025. Se analizaron los intervalos de dosificación al inicio, a los 6 y 12 meses, incluyendo únicamente a aquellos pacientes que recibieron al menos una dosis tras la fase de carga. Las tasas de persistencia se estimaron mediante análisis de supervivencia de Kaplan–Meier. Se incluyeron 129 pacientes (148 ojos), edad media 74,5 ± 8,85 años; 55% mujeres. 39 pacientes (30,2%) no pretratados y 90 (69,8%) pretratados con anti-VEGF. A los 12 meses, el 48,8% de los no pretratados y el 55,5% de los pretratados alcanzaron intervalos de 8–12 semanas. La persistencia media fue 12,2 meses (DE 0,2; IC 95%: 11,8–12,6), sin alcanzarse la mediana al finalizar el estudio. La tasa acumulada de persistencia fue del 93% a los 6 y 12 meses. Un paciente interrumpió el tratamiento por ineficacia. No se notificaron eventos adversos graves ni endoftalmitis. Faricimab mostró una excelente persistencia y capacidad para extender los intervalos de dosificación en práctica clínica real.