Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept
<i>Background and Objectives</i>: Faricimab is the first intravitreal injection of vascular endothelial growth factor-A and angiopoietin-2 bispecific monoclonal antibody. Here, we evaluate the functional and anatomical outcomes of faricimab treatment in patients with diabetic macular ede...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/6/1125 |
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| author | Hiromi Ohara Yosuke Harada Tomona Hiyama Ayako Sadahide Akira Minamoto Yoshiaki Kiuchi |
| author_facet | Hiromi Ohara Yosuke Harada Tomona Hiyama Ayako Sadahide Akira Minamoto Yoshiaki Kiuchi |
| author_sort | Hiromi Ohara |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Faricimab is the first intravitreal injection of vascular endothelial growth factor-A and angiopoietin-2 bispecific monoclonal antibody. Here, we evaluate the functional and anatomical outcomes of faricimab treatment in patients with diabetic macular edema (DME) that was refractory to ranibizumab or aflibercept. <i>Materials and Methods</i>: We performed a retrospective, observational, consecutive-case study of patients who had DME that was refractory to treatment with ranibizumab or aflibercept and were treated with faricimab between July 2022 and January 2023 under a pro re nata regimen. All the participants were followed for ≥4 months after the initiation of faricimab. The primary outcome was a recurrence interval of ≥12 weeks, and the secondary outcomes were the changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT). <i>Results</i>: We analyzed 18 eyes of 18 patients. The mean recurrence interval of previous anti-VEGF injection was 5.8 ± 2.5 weeks, which was significantly extended to 10.8 ± 4.9 weeks (<i>p</i> = 0.0005) by the switch to faricimab. Eight patients (44.4%) achieved a recurrence interval of ≥12 weeks. A history of subtenon injection of triamcinolone acetonide (<i>p</i> = 0.0034) and the presence of disorganization of the retinal inner layers (<i>p</i> = 0.0326) were found to be significantly associated with a recurrence interval of <12 weeks. The mean BCVAs were 0.23 ± 0.28 logMAR and 0.19 ± 0.23 logMAR, and the mean CMTs were 473.8 ± 222.0 µm and 381.3 ± 219.4 µm at baseline and 4 months, respectively, but these changes were not statistically significant. None of the patients experienced serious adverse events. <i>Conclusions</i>: Faricimab may extend the treatment interval for patients with DME that is refractory to ranibizumab or aflibercept. DME previously treated with the subtenon injection of triamcinolone acetonide or associated with disorganization of the retinal inner layers may be less likely to be associated with a longer recurrence interval after switching to faricimab. |
| first_indexed | 2024-03-11T02:11:48Z |
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| language | English |
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| spelling | doaj.art-ddb8b43b08a3441587ccc73286bef21c2023-11-18T11:31:50ZengMDPI AGMedicina1010-660X1648-91442023-06-01596112510.3390/medicina59061125Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or AfliberceptHiromi Ohara0Yosuke Harada1Tomona Hiyama2Ayako Sadahide3Akira Minamoto4Yoshiaki Kiuchi5Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan<i>Background and Objectives</i>: Faricimab is the first intravitreal injection of vascular endothelial growth factor-A and angiopoietin-2 bispecific monoclonal antibody. Here, we evaluate the functional and anatomical outcomes of faricimab treatment in patients with diabetic macular edema (DME) that was refractory to ranibizumab or aflibercept. <i>Materials and Methods</i>: We performed a retrospective, observational, consecutive-case study of patients who had DME that was refractory to treatment with ranibizumab or aflibercept and were treated with faricimab between July 2022 and January 2023 under a pro re nata regimen. All the participants were followed for ≥4 months after the initiation of faricimab. The primary outcome was a recurrence interval of ≥12 weeks, and the secondary outcomes were the changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT). <i>Results</i>: We analyzed 18 eyes of 18 patients. The mean recurrence interval of previous anti-VEGF injection was 5.8 ± 2.5 weeks, which was significantly extended to 10.8 ± 4.9 weeks (<i>p</i> = 0.0005) by the switch to faricimab. Eight patients (44.4%) achieved a recurrence interval of ≥12 weeks. A history of subtenon injection of triamcinolone acetonide (<i>p</i> = 0.0034) and the presence of disorganization of the retinal inner layers (<i>p</i> = 0.0326) were found to be significantly associated with a recurrence interval of <12 weeks. The mean BCVAs were 0.23 ± 0.28 logMAR and 0.19 ± 0.23 logMAR, and the mean CMTs were 473.8 ± 222.0 µm and 381.3 ± 219.4 µm at baseline and 4 months, respectively, but these changes were not statistically significant. None of the patients experienced serious adverse events. <i>Conclusions</i>: Faricimab may extend the treatment interval for patients with DME that is refractory to ranibizumab or aflibercept. DME previously treated with the subtenon injection of triamcinolone acetonide or associated with disorganization of the retinal inner layers may be less likely to be associated with a longer recurrence interval after switching to faricimab.https://www.mdpi.com/1648-9144/59/6/1125diabetic macular edemafaricimabranibizumabafliberceptvascular endothelial growth factorangiopoietin-2 |
| spellingShingle | Hiromi Ohara Yosuke Harada Tomona Hiyama Ayako Sadahide Akira Minamoto Yoshiaki Kiuchi Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept Medicina diabetic macular edema faricimab ranibizumab aflibercept vascular endothelial growth factor angiopoietin-2 |
| title | Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept |
| title_full | Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept |
| title_fullStr | Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept |
| title_full_unstemmed | Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept |
| title_short | Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept |
| title_sort | faricimab for diabetic macular edema in patients refractory to ranibizumab or aflibercept |
| topic | diabetic macular edema faricimab ranibizumab aflibercept vascular endothelial growth factor angiopoietin-2 |
| url | https://www.mdpi.com/1648-9144/59/6/1125 |
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