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Dual pathway inhibition with faricimab for previously treated neovascular age-related macular degeneration and diabetic macular oedema : guidance from a UK panel of retina specialists
Downey, Louise Sivaprasad, Sobha Chhabra, Ramandeep Bailey, Clare Chakrabarti, Soma Patel, Jignesh Silvestri, Giuliana Watson, Sarah-Lucie Williams, Gwyn
Downey, Louise
Sivaprasad, Sobha
Chhabra, Ramandeep
Bailey, Clare
Chakrabarti, Soma
Patel, Jignesh
Silvestri, Giuliana
Watson, Sarah-Lucie
Williams, Gwyn
Abstract
Background/objectives: Some eyes with neovascular age-related macular degeneration (nAMD) and centre-involving diabetic macular oedema (DMO) fail to respond sufficiently or lose response over time to standard of care intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. This paper explores clinical scenarios for switching to dual action angiopoietin-2 (Ang-2)/VEGF-A inhibitor faricimab (Vabysmo, Roche Products Limited) in previously anti-VEGF-treated patients.
Methods: A national steering group meeting of UK retina specialists was held in London on 27 October 2023. Clinician practice and experience were reviewed together with pivotal clinical trial data and early findings from real-world settings. Roche Products Limited facilitated and funded the meeting.
Results: While there is no standardised protocol for identifying suboptimal response, the authors review relevant clinical biomarkers of disease activity used in routine clinical practice to determine patient response and guide treatment decisions. Common reasons identified for considering a change of treatment were lack of efficacy demonstrated by suboptimal anatomic or visual improvement and insufficient durability of response. The panel outline strategies for switching to faricimab among eligible patients with a prior anti-VEGF treatment history, with initial monthly loading doses or maintaining the previous treatment interval before attempting to extend, that may be integrated into current treat-and-extend (T&E) clinical pathways for treating patients with nAMD and DMO. General considerations for switching between treatments are also reviewed.
Conclusion: Clinicians may consider a treatment switch to faricimab in nAMD and DMO patients who have suboptimal disease control or insufficient durability of response on initial anti-VEGF therapy.
MIDER Authors
Date
2024-11
Type
Article
Subject
Ophthalmology
Collections
Citation
Downey L, Sivaprasad S, Chhabra R, Bailey C, Chakrabarti S, Elsherbiny S, Patel J, Silvestri G, Watson SL, Williams G, Parker A, Khokhar S, Lotery A. Dual pathway inhibition with faricimab for previously treated neovascular age-related macular degeneration and diabetic macular oedema: guidance from a UK panel of retina specialists. Eye (Lond). 2024 Nov;38(16):3077-3086. doi: 10.1038/s41433-024-03223-w. Epub 2024 Aug 30.
Journal / Source Title
Eye
DOI
10.1038/s41433-024-03223-w
PMID
39215141
Publisher
Springer Nature
Publisher’s URL
https://pmc.ncbi.nlm.nih.gov/articles/PMC11544140/