Visual Acuity and Durability Outcomes of Faricimab Compared With Other Antivascular Endothelial Growth Factor Agents Within Routine Clinical Practice for Neovascular Age-Related Macular Degeneration

Purpose: To compare the visual acuity (VA) outcomes and dosing intervals of faricimab with those of other antivascular endothelial growth factor agents in treatment-naïve and treatment-experienced eyes with neovascular age-related macular degeneration (nAMD). Methods: De-identified electronic medical records (Vestrum Health treatment and outcomes database) of patients with nAMD treated with bevacizumab, ranibizumab, aflibercept, or faricimab between January 2021 and December 2023 were included. Mean VA change and mean number of days between injections were collected through 6 injections for treatment-naïve eyes and through 2 injections for treatment-switched eyes. Results: A total of 736 treatment-naïve eyes receiving faricimab experienced nonsignificantly lower VA gains than all other drugs; 5467 eyes switched to faricimab demonstrated lower VA gains relative to other drugs. This includes significantly lower gains than aflibercept or bevacizumab when switched from ranibizumab ( P < .01). Bevacizumab achieved the highest VA gains—significantly more than aflibercept ( P < .01) in the treatment-naïve cohort and significantly more than faricimab and aflibercept when switched from ranibizumab ( P < .01). After adjusting for significant VA differences at baseline and at the switch date, all drugs displayed similar VA gains in both cohorts. Compared with all other drugs, faricimab provided up to 4 additional days on average between injections and had the highest proportion of eyes extended over 50 days between the final 2 injections for both cohorts. Relative to aflibercept and ranibizumab, these injection frequencies for faricimab were significantly longer ( P < .01). Conclusions: Treatment-naïve and treatment-experienced nAMD eyes receiving faricimab demonstrated VA gains and minimally longer injection intervals, comparable to other antivascular endothelial growth factor agents.