Rishi P. SIngh, MD: Durability of Faricimab in Neovascular AMD Treatment

According to new data presented at the American Academy of Ophthalmology 2021 Meeting, faricimab, a bispecific Ang-2/VEGF-A inhibitor, at 16 weeks may be non-inferior in vision gains compared to aflibercept at 8 weeks in patients with neovascular age-related macular degeneration,

In an interview with HCPLive, Rishi P. SIngh, MD, Cole Eye Institute, Cleveland Clinic, discussed his paper “Faricimab in Neovascular AMD: Primary Results From the Phase 3 TENAYA and LUCERNE Trials.”

Singh overviewed the background of faricimab as a treatment of neovascular age-related macular degeneration and diabetic macular edema. He noted that although the current market agents tend to focus on the anti-VEGF pathway, which has shown positive results in the past, there are still issues in visual decline and durability issues.

“The purpose of this molecule is to both treat the VEGF pathway which we're all familiar with from the studies we've done, but also the angiopoietin-2 pathway which is a lesser known, important pathway for neovascular retinal diseases,” he said.

He explained how both TENAYA and LUCERNE determined a fair amount of durability of faricimab in patients who may have taken the agent at a rate of every 16 weeks. From the paper, data show 75 - 80% of patients achieved a Q12 week dosing interview or later, while the Q16 week dosing regimen showed 40 - 50% of the population matched the level of treatment.

“In practice right now, we don't really get that frequent of a treatment interval for our anti-VEGF options right now,” Singh noted. “This really offers both the provider and the patient really significant advantages in regards to the burden of care we endure with treating neovascular AMD.”

Additionally, Singh spoke on extended dosing strategies to improve the durability of drugs and assure that intermittent lapses of care do not thus cause detrimental results in patients. He pointed to the COVID-19 pandemic as an example, where a significant number of patients discontinued therapy or had treatment lapses that led to hospitalization.

“The goal of therapies like this one, faricimab in particular, which affects both the VEGF and the angiopoietin pathways, is that they potentially may improve the durability of these drugs so lapses and permanent visual losses won't necessarily be as damaging to people's eyes as we have seen in the past,” he said.