Work

Early anatomical outcomes of faricimab vs aflibercept 2 mg in treatment-naïve neovascular age-related macular degeneration and polypoidal choroidal vasculopathy: A head-to-head comparative study in Taiwan

Year: 2025

Type: article

Abstract: BACKGROUND: While clinical trials have established the non-inferiority of faricimab compared to aflibercept regarding 1-year visual acuity, real-world evidence directly comparing their early effects on anatomical changes remains limited. This study aimed to compare the early effects of these treatments in treatment-naïve Asian patients with neovascular age-related macular degeneration (nAMD) or polypoidal choroidal vasculopathy (PCV). METHODS: This retrospective study included treatment-naïve nAMD patients who received three monthly intravitreal injections of 6.0 mg/0.05 ml faricimab or 2.0 mg/0.05 ml aflibercept. Best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), pigment epithelial detachment (PED), subretinal fluid (SRF), intraretinal fluid (IRF), hyperreflective foci (HRF), and subretinal hyperreflective material (SHRM) were assessed monthly for 4 months. RESULTS: A total of 76 eyes of 76 patients (38 per group) were enrolled in this study. Baseline characteristics were comparable between the two groups, and there were no significant differences in BCVA, CMT, SFCT, SRF, and IRF at 4 months ( p > 0.05). However, the faricimab group had significant improvements in BCVA at months 2, 3, and 4 ( p < 0.05), while this was not seen in the aflibercept group. The decrease in mean logarithm of the minimum angle of resolution (logMAR) was from 0.78 ± 0.47 to 0.66 ± 0.65 in the faricimab group compared to 0.78 ± 0.41 to 0.72 ± 0.60 in the aflibercept group ( p = 0.348) at 4 months. Moreover, significantly fewer faricimab-treated patients had PED (67.6% vs 91.9%, p = 0.016), SHRM (32.4% vs 59.5%, p = 0.022), and HRF (52.9% vs 89.2%, p = 0.001) at 4 months. CONCLUSION: Faricimab and aflibercept demonstrated comparable effects on BCVA, CMT, and SFCT. However, faricimab was associated with better early control of PED, SHRM, and HRF. Further prospective trials are needed to validate our findings.

Source: Journal of the Chinese Medical Association

DOI: 10.1097/jcma.0000000000001320