Purpose: In this study, we investigated the treatment course of patients with neovascular age-related macular degeneration (nAMD) treated with anti-VEGF whose therapy was switched to intravitreal farisimab (IVF).
Patients and methods: Among patients with nAMD receiving anti-VEGF treatment with ranibizumab, aflibercept, brolucizumab, and ranibizumab biosimilar at Kansai Medical University Hospital, this study included 190 patients (198 eyes; mean age, 75.8±7.8 years; 122 males and 68 females) who could be followed up for 3 months after switching to IVF. We determined the administration regimen before switching (pro re nata [PRN] or modified treat-and-extend [mTAE] ), best corrected visual acuity changes in administration interval, and related adverse events after switching.
Results: Before switching, 105 and 93 eyes were classified into PRN and mTAE groups, respectively. The mean visual acuity (logarithmic minimum angle of resolution [logMAR] ) when switching to IVF was 0.34, whereas that at 1,2, and 3 months after switching was 0.36,0.37, and 0.38, respectively. Switching to IVF resulted in prolonged dosing intervals in 40 of 84 eyes (47.6%) in the mTAE group and 48 of 73 eyes (65.8%) in the PRN group. No systemic adverse events was observed in any case. However, iritis developed in two cases and vitritis in one case. These three cases started receiving the same anti-VEGF treatment that was used before switching.
Conclusions: Switching to IVF in patients with nAMD showed a favorable exudation control effect. In addition, 44.8% of patients who underwent mTAE and were treated with an interval of < 8 weeks could extend the dosing interval immediately after switching. Switching to IVF may reduce the number of administrations and hospital visits.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 128: 326-334, 2024.