Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Real-world durability of faricimab in treatment-naïve nAMD patients: outcomes of an observe-and-plan regimen.
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Scholand Lennart Erik, Sørensen Torben Lykke
Аннотация
BACKGROUND: This study aimed to evaluate the long-term durability and treatment-free intervals of treatment-naïve patients with neovascular age-related macular degeneration (nAMD) treated with faricimab under an observe-and-plan (O&P) regimen in a real-world setting.
METHODS: This retrospective, single-center cohort study included 410 treatment-naïve eyes with active nAMD. All eyes received an initial loading phase consisting of three monthly intravitreal injections of faricimab. At the first post-loading visit, patients were assigned to either the "pause group" or the "continue group" based on the presence of a dry macula. The primary outcomes included changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and treatment-free interval duration.
RESULTS: Post-loading, mean BCVA improved by + 3.6 letters (p < 0.001) while mean CRT decreased by 122.8 μm (p < 0.001). Overall, 68.5% of eyes (n = 281) achieved a dry macula and transitioned to the pause group. Within this group, the median treatment-free interval was 6.0 months (mean 7.1 ± 4.6 months), with 18.1% of patients remaining stable for > 52 weeks without the need for re-treatment. Baseline CRT was identified as a significant predictor of treatment extension. It was found to be significantly higher in the "continue group" than in the "pause group" (449.2 ± 148.9 vs. 403.8 ± 118.0 μm; p < 0.001). Age, sex, and baseline BCVA did not affect the duration of the treatment-free interval.
CONCLUSIONS: Faricimab demonstrates strong real-world efficacy, enabling immediate extension of treatment intervals under an O&P regimen. Baseline CRT is an important anatomical biomarker that helps tailor treatment regimens to individuals and reduce treatment burden.
METHODS: This retrospective, single-center cohort study included 410 treatment-naïve eyes with active nAMD. All eyes received an initial loading phase consisting of three monthly intravitreal injections of faricimab. At the first post-loading visit, patients were assigned to either the "pause group" or the "continue group" based on the presence of a dry macula. The primary outcomes included changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and treatment-free interval duration.
RESULTS: Post-loading, mean BCVA improved by + 3.6 letters (p < 0.001) while mean CRT decreased by 122.8 μm (p < 0.001). Overall, 68.5% of eyes (n = 281) achieved a dry macula and transitioned to the pause group. Within this group, the median treatment-free interval was 6.0 months (mean 7.1 ± 4.6 months), with 18.1% of patients remaining stable for > 52 weeks without the need for re-treatment. Baseline CRT was identified as a significant predictor of treatment extension. It was found to be significantly higher in the "continue group" than in the "pause group" (449.2 ± 148.9 vs. 403.8 ± 118.0 μm; p < 0.001). Age, sex, and baseline BCVA did not affect the duration of the treatment-free interval.
CONCLUSIONS: Faricimab demonstrates strong real-world efficacy, enabling immediate extension of treatment intervals under an O&P regimen. Baseline CRT is an important anatomical biomarker that helps tailor treatment regimens to individuals and reduce treatment burden.