Treatment Effects of Switching to Faricimab in Eyes with Diabetic Macular Edema Refractory to Aflibercept

Author:

Tatsumi Tomoaki1ORCID,Kaiho Tomomi1,Iwase Takehito1,Miura Gen1ORCID,Shimizu Daisuke1,Niizawa Tomohiro1,Ozawa Yoshihito2ORCID,Arai Miyuki13,Oshitari Toshiyuki14ORCID,Takatsuna Yoko15ORCID,Baba Takayuki1

Affiliation:

1. Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan

2. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan

3. National Hospital Organization Chiba Medical Center, 4-1-2, Tsubakimori, Chuo-ku, Chiba 260-8606, Japan

4. Department of Ophthalmology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita 286-8686, Japan

5. Chiba Rosai Hospital, 2-16, Tatsumidaihigashi, Ichihara 290-0003, Japan

Abstract

Background and Objectives: Faricimab is a vascular endothelial growth factor A and angiopoietin-2 bispecific antibody. It is a novel therapeutic approach distinct from previous anti-vascular endothelial growth factor agents. This study aimed to evaluate the efficacy of switching from aflibercept to faricimab in the treatment of diabetic macular edema (DME) refractory to aflibercept, with a specific focus on the resolution of macular edema. Materials and Methods: The medical records of 29 eyes of 21 patients with DME that were refractory to intravitreal injections of aflibercept (IVAs) and who had completed the clinical follow-up of at least four intravitreal injections of faricimab (IVFs) were reviewed. The central retinal thickness (CRT), best-corrected visual acuity (BCVA), and the mean period (weeks) until the next injection were measured after the second-to-last IVA, first-to-last IVA, last IVA, and first to fourth IVFs following the transition to IVF. Results: The mean time from the first IVF to the assessment of effectiveness was significantly shorter than the time to the last IVA; however, no significant difference was found in the time from the second, third, and fourth IVFs to the assessment. The mean CRTs after the first and second IVFs were not significantly different from the CRT after the last IVA, but the mean CRT after the third and fourth IVFs was significantly thinner than that after the last IVA (p = 0.0025 and p = 0.0076, respectively). The mean BCVAs after the third and fourth IVFs significantly improved compared with that after the last IVA (p = 0.0050 and p = 0.0052, respectively). Conclusions: When switching the treatment to IVF for eyes with IVA-resistant DME, better treatment outcomes are achieved if IVF is performed three or more times.

Funder

Ministry of Education, Science, Sports, and Culture of the Japanese Government

Publisher

MDPI AG

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