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.

Autor: Downey L; Hull University Teaching Hospitals NHS Trust, Hull, UK. Louise.downey1@nhs.net., Sivaprasad S; NIHR Moorfields Clinical Research Facility, Moorfields Eye Hospital NHS Foundation Trust, London, UK., Chhabra R; Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Bailey C; University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK., Chakrabarti S; NHS Greater Glasgow & Clyde, Glasgow, UK., Elsherbiny S; South Warwickshire University NHS Foundation Trust, Warwick, UK., Patel J; Colchester District General Hospital, Colchester, UK., Silvestri G; Belfast Health and Social Care Trust, Belfast, UK., Watson SL; Royal Berkshire NHS Foundation Trust, Reading, UK., Williams G; Swansea Bay University Health Board, Singleton Hospital, Swansea, UK., Parker A; Roche Products Limited, Welwyn Garden City, UK., Khokhar S; Roche Products Limited, Welwyn Garden City, UK., Lotery A; Southampton Eye Unit and Faculty of Medicine, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2024 Nov; Vol. 38 (16), pp. 3077-3086. Date of Electronic Publication: 2024 Aug 30.
DOI: 10.1038/s41433-024-03223-w
Abstrakt: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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