Faricimab Demonstrates Positive Outcomes for Treatment-Naive Neovascular AMD, Extending Treatment Intervals
A novel bispecific antibody, faricimab, shows promise in improving visual outcomes and extending treatment intervals for patients with treatment-naive neovascular age-related macular degeneration (nAMD), according to a recent retrospective analysis. The study, published in Ophthalmology and Therapy in 2025, revealed that after 12 months, 39.2% of eyes achieved a treatment interval of 12 weeks or longer, and more than half of patients with retinal fluid at baseline experienced complete fluid resolution.
Researchers, led by Anne Tillmann of Augenarzt Praxisgemeinschaft Gutblick AG in Switzerland, retrospectively analyzed data from 130 eyes of 118 patients diagnosed with treatment-naive nAMD. Participants received Vabysmo (faricimab-svoa, Genentech) between May 2022 and October 2024 at 11 specialized ophthalmic centers across Switzerland. The study employed a treat-and-extend protocol, allowing physicians to adjust treatment intervals based on individual patient response. Primary outcomes focused on changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and treatment intervals over the 12-month study period.
The analysis showed a significant improvement in average BCVA, increasing from 64.6 ± 14.1 ETDRS letters at baseline to 69.2 ± 20.3 ETDRS letters after 12 months of faricimab treatment (P < .001). Furthermore, average CRT decreased significantly from 386.3 ± 172.3 µm to 246.6 ± 90.4 µm (P < .001). Notably, intraretinal and/or subretinal fluid was present in all 130 eyes at the study’s outset; however, 34.6% achieved complete retinal fluid resolution after the first injection, with that number rising to 55.6% after 12 months.
By the study’s conclusion, the average treatment interval had extended to 10.5 ± 4.3 weeks. Specifically, 26.2% of eyes reached intervals between 8 and 11 weeks, while 39.2% achieved intervals of 12 weeks or longer. The study reported no serious adverse events, with only one case of anterior uveitis, two instances of retinal pigment epithelium tears, and one case of minor macular bleeding observed.
“While fewer eyes achieved very extended injection intervals compared to pivotal randomized trials, the results affirm faricimab’s effectiveness and tolerability in routine clinical practice,” Tillmann and colleagues wrote. “These data support the clinical utility of faricimab as a first-line therapy for nAMD and highlight the need for further prospective, long-term studies to optimize treatment regimens and assess outcomes in broader, more diverse patient populations.”
In a perspective piece accompanying the study, Jonathan Chen, OD, FAAO, FSLS, of Vision Source InSight Eyecare, highlighted the potential for reduced dosing frequency with this dual-pathway treatment. He noted that the real-world data mirrored the reduction in central retinal thickness observed in pivotal trials, but with a slightly lower percentage of patients achieving extended treatment intervals. This difference, Chen explained, likely reflects individualized re-treatment decisions based on optical coherence tomography (OCT) and exam findings, rather than the strict dosing algorithms of clinical trials. He also emphasized that early structural improvements did not consistently predict long-term response.
For optometrists, who often serve as the first point of contact for nAMD detection and referral, this information is valuable for counseling patients about treatment expectations and burden. Longer intervals between treatments, while still improving visual outcomes, can significantly reduce the burden on both patients and clinics. However, Chen cautioned that the retrospective nature of the study, with its small sample size and 1-year follow-up, limits broad generalizations. He suggested that a prospective, multicenter study is needed to identify which patient groups benefit most from faricimab therapy and to account for racial demographics and lesion types.
