Visual Acuity and Durability Outcomes of Faricimab Compared With Other Antivascular Endothelial Growth Factor Agents Within Routine Clinical Practice for Diabetic Macular Edema

Abstract

Purpose: To assess visual outcomes and dosing frequencies of faricimab compared with other antivascular endothelial growth factor agents in treatment-naïve and treatment-experienced eyes with diabetic macular edema. Methods: The de-identified electronic medical records of patients with diabetic macular edema in the Vestrum Health database between January 2021 and December 2023 were analyzed, including eyes treated with faricimab, bevacizumab, ranibizumab, and aflibercept. Through 6 injections for treatment-naïve eyes and 2 injections for treatment-experienced eyes, we recorded changes in mean visual acuity (VA) and mean number of days between injections. Results: By injection 6, a total of 14 103 treatment-naïve eyes receiving faricimab (n = 167), bevacizumab (n = 7529), ranibizumab (n = 1433), and aflibercept (n = 4947) gained 4.6, 7.3, 7.1, and 6.7 letters, respectively. After stratifying by baseline VA, mean VA change in faricimab-treated eyes was statistically similar to that of eyes treated with other agents. After 2 injections, in 1378 eyes switched to faricimab from aflibercept, bevacizumab, and ranibizumab, mean letters gained were 0.8, 0.8, and 3.1, respectively. Eyes switched to faricimab improved similarly to those switched to aflibercept and ranibizumab, but had worse outcomes than eyes switched to bevacizumab (P < .01). The percentage of treatment-naïve eyes treated with faricimab that reached 50 or more mean days between injections 5 and 6 was significantly greater than eyes treated with bevacizumab and ranibizumab (P < .01 for both). Conclusions: VA outcomes for treatment-naïve eyes receiving faricimab were similar to those of other eyes after adjustment for baseline VA. Furthermore, our findings suggest that faricimab may offer better durability outcomes than other antivascular endothelial growth factor agents.