Marco A. Zarbin, MD, PhD: Benefit of Faricimab for DME with BCVA ≤20/50

A posthoc analysis of the phase 3 YOSEMITE and RHINE trials found faricimab treatment led to comparable vision outcomes with fewer injections than aflibercept among patients with diabetic macular edema (DME) with baseline best-corrected visual acuity (BCVA) of 20/50 or worse.

The results, presented at the 127th Annual American Academy of Ophthalmology (AAO) Meeting in San Francisco, California, showed comparable changes in BCVA between the faricimab and aflibercept treatment arms, and superior reduction in central subfield thickness (CST) for faricimab at years 1 and 2.

According to the analysis, the durability achieved in the faricimab treat-and-extend arms across both trials indicates vision outcomes with superior drying, fewer injections, and comparable vision outcomes, suggesting a reduction in treatment burden across patients, providers, and payers.

“That may be one of the benefits of faricimab, that you’re not only going to get drier faster with fewer injections, but more of your patients are going to get completely dry than with aflibercept,” said Marco A. Zarbin, MD, PhD, a professor of ophthalmology at Rutgers New Jersey Medical School. “In terms of the durability, close to 76% of patients could be injected somewhere between every 12 to 16 weeks, which is really, very good durability.”

The pooled posthoc analysis was conducted using the combined DME intent-to-treat population from the YOSEMITE and RHINE trials with a baseline BCVA of ≤20/50. Changes from baseline in BCVA and CST at years 1 and 2 were compared between faricimab every 8 weeks, personalized treatment interval dosing, and aflibercept every 8-week arms. Investigators also assessed treatment intervals achieved at years 1 and 2 for faricimab treat-and-extend arms.

“I think that really, this drug, at least in this post-hoc analysis really demonstrates a significant improvement over what was previously available to treat patients with DME,” Zarbin said.

Given the favorable safety profile, Zarbin noted he plans to switch as many patients as possible and begin patients on faricimab, not due to visual outcomes, but to achieve zero fluid in the retina faster and with fewer injections.

“Coming in for a doctor’s appointment is a big deal,” he said.” When you are working, it basically takes you a whole day off from work. From the point of view of helping to keep people functional and operational, as well as healthy, I think it offers a lot of important advantages.”

For more insight into the post hoc analysis, watch the full interview with Dr. Zarbin.

References

_{Zarbin M, Tabano D, Ahmed A, Amador M, Ding A, Holekamp, Lu X, Stoliov Y, Yang M. Clinical Outcomes of Diabetic Macular Edema Patients Treated With Faricimab and Aflibercept: A Subcohort Analysis of 20/50 or Worse Visual Acuity Across Faricimab Phase 3 Clinical Trials: A Pooled Subcohort Analysis. Presented at the 2023 American Academy of Ophthalmology Annual Meeting, November 3 – 6, 2023.}