Comparison of Initial Loading Injection Outcomes Between Aflibercept 8 mg and Faricimab in Neovascular Age-Related Macular Degeneration

Abstract

Purpose: To evaluate and compare the initial functional and anatomical outcomes of aflibercept 8 mg and faricimab during the loading phase in treatment-naïve neovascular age-related macular degeneration (AMD).

Methods: This retrospective observational study included 100 eyes of 100 patients with treatment-naïve neovascular AMD who were administered three consecutive monthly loading injections of either aflibercept 8 mg (aflibercept 8 mg group, n=51) or faricimab (faricimab group, n=49). Changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT), as well as complete resolution of subretinal and intraretinal fluids, were compared between groups. Within each group, BCVA and CRT at baseline were compared with values at 3 months.

Results: In the aflibercept 8 mg group, mean BCVA, measured in logarithm of the minimal angle of resolution (logMAR), improved from 0.59±0.51 (Snellen equivalent, 20/77) at baseline to 0.39±0.44(20/49) at 3 months(P<0.001). Correspondingly, mean CRT decreased from 450.6±157.0 µm to 287.3±82.3 µm(P<0.001). In the faricimab group, mean BCVA improved from 0.62±0.47 logMAR(20/83) to 0.45±0.38(20/56)(P<0.001), and mean CRT decreased from 442.4±163.8 µm to 248.5±81.2 µm(P<0.001). No significant differences were observed between groups in BCVA improvement(P=0.685) or CRT reduction(P=0.320). Complete retinal fluid resolution was observed in 80.4% and 87.8% of patients in the aflibercept 8 mg and faricimab groups, respectively, with no significant difference in fluid resolution between groups(P=0.234).

Conclusions: Aflibercept 8 mg and faricimab achieved significant and comparable functional and anatomical outcomes after three loading injections in treatment-naïve neovascular AMD, suggesting that either agent may serve as an effective first-line treatment for this condition.

Keywords: Age-related macular degeneration; aflibercept; aflibercept 8mg; faricimab; loading injections; macular neovascularization.