Rapid Fluid Resolution with Faricimab Predicts Long-Term Treatment Durability in nAMD

Introduction

Neovascular age-related macular degeneration (nAMD) remains a primary cause of severe vision loss globally. While the advent of vascular endothelial growth factor (VEGF) inhibitors revolutionized the management of this condition, the treatment burden associated with frequent intravitreal injections remains a significant challenge for both patients and healthcare systems. In clinical practice, the goal is to achieve a dry macula while extending treatment intervals to the maximum extent possible without compromising visual acuity. Faricimab, the first bispecific antibody designed for intraocular use, targets both VEGF-A and angiopoietin-2 (Ang-2), aiming to provide enhanced vascular stability and durability compared to traditional anti-VEGF monotherapy.

Recent data from the phase 3 TENAYA and LUCERNE randomized clinical trials (RCTs) demonstrated that faricimab is noninferior to aflibercept while allowing for extended dosing intervals in a majority of patients. A critical question for clinicians is whether early anatomical responses can serve as a prognostic indicator for long-term durability. This post hoc analysis investigates whether rapid resolution of intraretinal fluid (IRF) and subretinal fluid (SRF) by week 12 is associated with the ability to maintain extended dosing intervals through week 112.