Real-World Outcomes in Eyes With Neovascular AMD Switched From Brolucizumab to Faricimab: A TRUCKEE Study Analysis.

Abstract

To investigate anatomical and functional outcomes in a subset of eyes with neovascular age-related macular degeneration (nAMD) switched from brolucizumab to faricimab in the real-world TRUCKEE study. Retrospective, multicentric clinical cohort study. 134 eyes of 108 patients were switched from brolucizumab to faricimab. This study included 56 eyes (49 patients) with complete data after 1 injection of faricimab and 40 eyes (34 patients) with complete data after 3 injections of faricimab. A multicenter, retrospective chart review was conducted on real-world participants enrolled in the TRUCKEE study switched from brolucizumab to faricimab for the treatment of nAMD. Participants were considered eligible for this post-hoc analysis if they had documented anatomical and functional outcome data following 1 and 3 injections of faricimab after being switched from brolucizumab. A comparative analysis was performed using the Wilcoxon signed-rank test. Change in best corrected visual acuity (BCVA) measured in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters, durability - defined as time interval between treatments in days, and central subfield thickness (CST), following 1 and 3 injections of faricimab. The mean age of patients who had complete data after 1 injection of faricimab was 81.1 ± 7.1 years, and 25 were males. After 1 injection of faricimab following the switch, (mean treatment interval of 57.0 ± 32.9 days) a significant reduction in CST was observed (mean -5.25 µm, P = .048). Changes in BCVA and durability were not statistically significant after 1 injection. The mean age of patients who had data after 3 injections was 80.4±7.7 years, and 16 were males. The mean CST reduction measured -11.28 µm, when comparing post-faricimab with post-brolucizumab values (P = .086). Additionally, after 3 injections of faricimab, a numerical increase in retreatment interval (+5.0 days, P = .769) and improvement in visual acuity (BCVA +1.63 letters, P = .174) were observed, though these were not statistically significant. Switching from brolucizumab to faricimab was associated with numerical improvements in BCVA, CST, and retreatment interval. The apparent benefit in patients already on maximum VEGF suppression with brolucizumab, may suggest the relevance of angiopoetin-2 suppression with faricimab.