OBJECTIVES: To evaluate the potential benefit of faricimab, a new targeting vascular endothelial growth factor A (VEGF-A) and Angiopoietin-2, versus the current intravitreal (IV) a-VEGF SoC in nAMD patients.

METHODS: Patient-level data from the companion phase III clinical trials TENAYA and LUCERNE (faricimab; n=513) and the RADIANCE observational study (SoC: n=263; including aflibercept: n=101, bevacizumab: n=53, ranibizumab: n=59) were used. The investigation included naïve nAMD patients with effectiveness data at one year follow-up available. Effectiveness was assessed in terms of change from baseline in best-corrected visual acuity (BCVA) and central subfield thickness (CST). Propensity score weighting (PSW) was used to balance demographic and clinical patients’ characteristics between the faricimab and the SoC cohorts. Weighted one-way ANOVA was applied to compare changes in BCVA and CST between groups. A sensitivity analysis to adjust for injections’ number was conducted using weighted ANCOVA.

RESULTS: After PSW, mean vision gains in BCVA after 1 year of treatment were 6.5 letters (95% confidence interval, CI: 5.0, 7.9) in the faricimab and 1.0 (95% CI: -0.4, 2.5) in the SoC groups, with a corresponding treatment difference of 5.4 letters (95% CI: 3.4, 7.5, p<0.001) in favour of faricimab. Mean CST change from baseline was -143.2 μm (95% CI: -156.2, -130.1) with faricimab and -71.4 μm (95% CI: -84.3, -58.4) with SoC, with a corresponding treatment difference of -71.8 μm (95% CI: -90.2, -53.4, p<0.001). Results were confirmed in sensitivity analyses: treatment differences in favor of faricimab was +4.0 letters in BCVA and -71.8 μm in CST reduction.

CONCLUSIONS: In naive nAMD patients, first line treatment with faricimab resulted in a greater vision gain and CST reduction compared with current SoC. Despite limitations of indirect treatment comparisons, which call for specific post-marketing real world studies, the present analysis supports potential benefits in nAMD patients treated with faricimab.