Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 23;9(1):e001702.
doi: 10.1136/bmjophth-2024-001702.

Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis

Daniel Samacá-Samacá  1 , Claudia Hernández-Castillo  2 , Laura Prieto-Pinto  3 , Francisco Rodríguez  4   5 , Carolina Sardi  6 , Hugo Ocampo  7 , Joshua Kock  3 , Fabián Hernández  2
Affiliations

Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis

Daniel Samacá-Samacá et al. BMJ Open Ophthalmol. .

Abstract

Objective: To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients.

Methods and analysis: A systematic review (SR) was conducted up to January 2023. Network meta-analyses (NMA) were performed, including sensitivity and subgroup analyses for naïve population. Outcomes included changes in visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] letters), anatomical changes, frequency of injections and adverse events. The Cochrane Collaboration guidelines and the Confidence in Network Meta-Analysis framework were used for the SR and the certainty of evidence, respectively.

Results: From 4128 identified records through electronic databases and complementary searches, 63 randomised controlled trials (RCTs) met the eligibility criteria, with 42 included in the NMA. Faricimab showed a significant reduction in the number of annual injections compared with most fixed and flexible anti-VEGF treatment regimens, while showing no statistically significant differences in visual acuity through ETDRS letter gain, demonstrating a comparable efficacy. Retinal thickness results showed comparable efficacy to other anti-VEGF agents, and inferior only to brolucizumab. Results also showed that more patients treated with faricimab were free from post-treatment retinal fluid compared with aflibercept every 8 weeks, and both ranibizumab and bevacizumab, in the fixed and pro re nata (PRN) assessed schedules. Faricimab showed a comparable safety profile regarding the risk of ocular adverse events and serious ocular adverse events (SOAE), except for the comparison with brolucizumab quarterly, in which faricimab showed a significant reduction for SOAE risk.

Conclusion: Faricimab showed a comparable clinical benefit in efficacy and safety outcomes, with a reduction in annual injections compared with fixed and flexible anti-VEGF drug regimens, representing a valuable treatment option for nAMD patients.

Prospero registration number: CRD42023394226.

Keywords: Macula; Neovascularisation; Retina; Treatment Medical.

PubMed Disclaimer

Conflict of interest statement

Competing interests: RF, CS and OH have declared financial support from pharmaceutical companies, including Bayer, Novartis, Astellas, Abbvie and Roche, for conferences and academic meetings, as well as for consulting fees and Advisory Boards. DS-S, P-PL and KJ are employees of Roche, Colombia. None of the authors received any compensation for the authorship of this manuscript. IQVIA served as consultant company for Roche for the development of the study. The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1
Figure 1. Flow diagram (PRISMA 2020). NMA, network meta-analyses; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2. Risk of bias contributions and network geometry for the comparison of anti-VEGF agents for age-related macular degeneration neovascular (BCVA). (A) Risk of bias contributions for the comparison for BCVA. (B) Network geometry for mean change in BCVA. Afli, aflibercept; Beva, bevacizumab; Brolu, brolucizumab; Fari, faricimab; LD, loading dose; PRN, pro re nata; Rani, ranibizumab; T&E treat and extend; VEGF, vascular endothelial growth factor; q4w, q8w, q12w, q16w, injections every 4, 8, 12 and 16 weeks, respectively.
Figure 3
Figure 3. Forest plot for efficacy outcomes at 1 year comparing faricimab 6 mg up to q16w with other anti-VEGF agents. (A) Forest plot for mean change in BCVA for faricimab 6 mg up to q16w compared with other anti-VEGF agents. (B) Forest plot for retinal thickness for faricimab 6 mg up to q16w compared with other anti-VEGF agents. (C) Forest plot for the number of injections received by each treatment regimen comparing faricimab 6 mg up to q16w to other anti-VEGF agents. (D) Forest plot for the sensibility analysis of the number of injections received by each treatment regimen comparing faricimab 6 mg up to q16w to other anti-VEGF agents. Afli, aflibercept; Beva, bevacizumab; Brolu, brolucizumab; Fari, faricimab; LD, loading dose; PRN, pro re nata; PRNX, pro re nata with possibility of interval extension; Rani, ranibizumab; T&E, treat and extend; VEGF, vascular endothelial growth factor; q4w, q8w, q12w, q16w, injections every 4, 8, 12 and 16 weeks, respectively.
Figure 4
Figure 4. Network geometry and forest plot for ocular adverse events and serious ocular adverse events comparing faricimab 6 mg up to q16w with other anti-VEGF agents. (A) Network geometry for ocular adverse events. (B) Forest plot for ocular adverse events comparing faricimab 6 mg up to q16w to other anti-VEGF agents. (C) Network geometry for serious ocular adverse events. (D) Forest plot for serious ocular adverse events comparing faricimab 6 mg up to q16w to other anti-VEGF agents. Afli, aflibercept; Beva, bevacizumab; Fari, faricimab; LD, loading dose; PRN, pro re nata; PRNX, pro re nata with possibility of interval extension; Rani, ranibizumab; T&E, treat and extend; VEGF, vascular endothelial growth factor; q4w, q8w, q12w, q16w, injections every 4, 8, 12 and 16 weeks, respectively.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization (WHO) Vision 2020 the right to sight. Global iniciative for the elimination of avoidable blindness. action plan 2006-2011. 2007:1–89.
    1. Keenan TD, Cukras CA, Chew EY. Age-related Macular Degeneration. vol 1256. Springer, Cham; 2021. Age-related macular degeneration: epidemiology and clinical aspects. - PubMed
    1. Jonas JB, Cheung CMG, Panda-Jonas S. Updates on the epidemiology of age-related macular degeneration. Asia Pac J Ophthalmol (Phila) 2017;6:493–7. doi: 10.22608/APO.2017251. - DOI - PubMed
    1. Lanzetta P, Loewenstein A, Vision Academy Steering C. Fundamental principles of an anti-VEGF treatment regimen: optimal application of intravitreal anti-vascular endothelial growth factor therapy of macular diseases. Graefes Arch Clin Exp Ophthalmol. 2017;255:1259–73. doi: 10.1007/s00417-017-3647-4. - DOI - PMC - PubMed
    1. Fabre M, Mateo L, Lamaa D, et al. Recent advances in age-related macular degeneration therapies. Molecules. 2022;27:5089. doi: 10.3390/molecules27165089. - DOI - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources