Faricimab trumps aflibercept in diabetic macular edema

Treatment with faricimab demonstrates similar visual acuity and greater retinal thickness reduction, with fewer injections, when compared with aflibercept therapy in patients with diabetic macular edema (DME), reports a recent study.

Investigators conducted phase III multicentre, randomized, double-blind noninferiority trials (YOSEMITE and RHINE) in adults aged ≥18 years with centre-involving macular edema secondary to type 1 or 2 diabetes. They randomized eligible participants to receive faricimab every 8 weeks (Q8W), faricimab personalized treat-and-extend (T&E) regimen, or aflibercept Q8W.

Additionally, an intention-to-treat population with baseline best-corrected visual acuity (BCVA) of 20/50 or worse was included in post hoc subgroup analyses.

In YOSEMITE and RHINE, 220 and 217 patients in the faricimab Q8W arm, 220 and 219 in the faricimab T&E arm, and 219 and 214 in the aflibercept Q8W arm had baseline BCVA of 20/50 or worse, respectively. At years 1 and 2, the mean change in ETDRS BCVA was similar between treatment arms across YOSEMITE and RHINE trials.

In YOSEMITE, the adjusted mean change from baseline in central subfield thickness (CST) at 1 year was greater with faricimab Q8W (p<0.0001) and T&E (p=0.0006) than with aflibercept Q8W (–232.8 and –214.2 vs –190.4 μm). The same trend was noted in RHINE (–214.2 [p=0.0006] and –206.6 [p=0.0116] vs –186.6 μm).

At year 2, the change from baseline in CST was also higher in the faricimab Q8W arm than the aflibercept arm in both YOSEMITE and RHINE. In addition, the faricimab arms had shorter median time to first CST of <325 μm and first absence of intraretinal fluid, as well as fewer injections on average, than the aflibercept arm.