Jaskaran Singh Bhangu, Parinita Keshav Swarnkar, Christopher Stewart, Mohammed Rifat, Sarah Khalid, Ahmed Al-Janabi, Mahmoud Husseiny Awad, Gwyn Samuel Williams
In this real-world audit, treatment with Faricimab was associated with higher discharge rates, earlier discharge, and fewer readmissions compared with aflibercept, although these findings should be interpreted as observational associations rather than causal effects. Lesion type did not appear to be an independent predictor of these service outcomes within the limits of this analysis.
BACKGROUND: Anti-VEGF treatment improves outcomes in neovascular age-related macular degeneration (nAMD) management. No real-world data have compared discharge and readmission rates between Faricimab and Aflibercept 2mg, stratified by lesion type.
METHODS: A retrospective audit study of 1004 eyes in 912 patients diagnosed with nAMD. Patients received either Faricimab or Aflibercept 2mg. The outcomes assessed were central macular thickness CMT, best-corrected visual acuity BCVA, fluid resolution, discharge to community care defined as being asymptomatic for more than 6 months and then reviewed by optometrist, and readmission. Lesion types were classified into Type 1, Type 2, and Prepapillary. Statistical analysis used t-tests, chi-square, and appropriate nonparametric tests.
RESULTS: The demographic of the patients in this study consisted of 60.6% of women with participants being on average 76.9 years old. Type 1 lesions had a greater change from baseline CMT, and a greater change in BCVA than Type 2 lesions. Discharge rates from hospital and the average time to discharge from hospital was greater for Faricimab (84.1%, 378 days) compared with Aflibercept (69.5%, 1048 days, p < 0.0001). The number of eyes readmitted was lower for Faricimab (14.7% vs 29.1%) and was not different for lesion type (p = 0.96). The number of injections was not different amongst discharged patients and readmitted patients. In this retrospective cohort, service outcomes at discharge and readmission appeared to differ between Faricimab and aflibercept, whereas no clear differences were observed by lesion type.
CONCLUSION: In this real-world audit, treatment with Faricimab was associated with higher discharge rates, earlier discharge, and fewer readmissions compared with aflibercept, although these findings should be interpreted as observational associations rather than causal effects. Lesion type did not appear to be an independent predictor of these service outcomes within the limits of this analysis.