Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis
Objective To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients.Methods and analysis A systematic review (SR) was conducted up to January 2023. Network m...
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BMJ Publishing Group
2024-05-01
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Series: | BMJ Open Ophthalmology |
Online Access: | https://bmjophth.bmj.com/content/9/1/e001702.full |
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author | Francisco Rodríguez Daniel Samacá-Samacá Claudia Hernández-Castillo Laura Prieto-Pinto Carolina Sardi Hugo Ocampo Joshua Kock Fabián Hernández |
author_facet | Francisco Rodríguez Daniel Samacá-Samacá Claudia Hernández-Castillo Laura Prieto-Pinto Carolina Sardi Hugo Ocampo Joshua Kock Fabián Hernández |
author_sort | Francisco Rodríguez |
collection | DOAJ |
description | Objective To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients.Methods and analysis A systematic review (SR) was conducted up to January 2023. Network meta-analyses (NMA) were performed, including sensitivity and subgroup analyses for naïve population. Outcomes included changes in visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] letters), anatomical changes, frequency of injections and adverse events. The Cochrane Collaboration guidelines and the Confidence in Network Meta-Analysis framework were used for the SR and the certainty of evidence, respectively.Results From 4128 identified records through electronic databases and complementary searches, 63 randomised controlled trials (RCTs) met the eligibility criteria, with 42 included in the NMA. Faricimab showed a significant reduction in the number of annual injections compared with most fixed and flexible anti-VEGF treatment regimens, while showing no statistically significant differences in visual acuity through ETDRS letter gain, demonstrating a comparable efficacy. Retinal thickness results showed comparable efficacy to other anti-VEGF agents, and inferior only to brolucizumab. Results also showed that more patients treated with faricimab were free from post-treatment retinal fluid compared with aflibercept every 8 weeks, and both ranibizumab and bevacizumab, in the fixed and pro re nata (PRN) assessed schedules. Faricimab showed a comparable safety profile regarding the risk of ocular adverse events and serious ocular adverse events (SOAE), except for the comparison with brolucizumab quarterly, in which faricimab showed a significant reduction for SOAE risk.Conclusion Faricimab showed a comparable clinical benefit in efficacy and safety outcomes, with a reduction in annual injections compared with fixed and flexible anti-VEGF drug regimens, representing a valuable treatment option for nAMD patients.PROSPERO registration number CRD42023394226. |
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institution | Kabale University |
issn | 2397-3269 |
language | English |
publishDate | 2024-05-01 |
publisher | BMJ Publishing Group |
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series | BMJ Open Ophthalmology |
spelling | doaj-art-af7e7198d46a47778a6e52ac92aa3b852025-02-06T14:15:12ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692024-05-019110.1136/bmjophth-2024-001702Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysisFrancisco Rodríguez0Daniel Samacá-Samacá1Claudia Hernández-Castillo2Laura Prieto-Pinto3Carolina Sardi4Hugo Ocampo5Joshua Kock6Fabián Hernández7FUNDONAL, Bogota, ColombiaEvidence Generation, Roche Colombia, Bogotá D.C, ColombiaReal World Insights, IQVIA Solutions, Bogotá D.C, ColombiaEvidence Generation, Roche Colombia, Bogotá D.C, ColombiaInstituto Nacional de Investigación en Oftalmología, Medellín, ColombiaClínica de Oftalmología, Cali, ColombiaEvidence Generation, Roche Colombia, Bogotá D.C, ColombiaReal World Insights, IQVIA Solutions, Bogotá D.C, ColombiaObjective To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients.Methods and analysis A systematic review (SR) was conducted up to January 2023. Network meta-analyses (NMA) were performed, including sensitivity and subgroup analyses for naïve population. Outcomes included changes in visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] letters), anatomical changes, frequency of injections and adverse events. The Cochrane Collaboration guidelines and the Confidence in Network Meta-Analysis framework were used for the SR and the certainty of evidence, respectively.Results From 4128 identified records through electronic databases and complementary searches, 63 randomised controlled trials (RCTs) met the eligibility criteria, with 42 included in the NMA. Faricimab showed a significant reduction in the number of annual injections compared with most fixed and flexible anti-VEGF treatment regimens, while showing no statistically significant differences in visual acuity through ETDRS letter gain, demonstrating a comparable efficacy. Retinal thickness results showed comparable efficacy to other anti-VEGF agents, and inferior only to brolucizumab. Results also showed that more patients treated with faricimab were free from post-treatment retinal fluid compared with aflibercept every 8 weeks, and both ranibizumab and bevacizumab, in the fixed and pro re nata (PRN) assessed schedules. Faricimab showed a comparable safety profile regarding the risk of ocular adverse events and serious ocular adverse events (SOAE), except for the comparison with brolucizumab quarterly, in which faricimab showed a significant reduction for SOAE risk.Conclusion Faricimab showed a comparable clinical benefit in efficacy and safety outcomes, with a reduction in annual injections compared with fixed and flexible anti-VEGF drug regimens, representing a valuable treatment option for nAMD patients.PROSPERO registration number CRD42023394226.https://bmjophth.bmj.com/content/9/1/e001702.full |
spellingShingle | Francisco Rodríguez Daniel Samacá-Samacá Claudia Hernández-Castillo Laura Prieto-Pinto Carolina Sardi Hugo Ocampo Joshua Kock Fabián Hernández Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis BMJ Open Ophthalmology |
title | Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis |
title_full | Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis |
title_fullStr | Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis |
title_full_unstemmed | Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis |
title_short | Efficacy and safety of faricimab for neovascular age-related macular degeneration: a systematic review and network meta-analysis |
title_sort | efficacy and safety of faricimab for neovascular age related macular degeneration a systematic review and network meta analysis |
url | https://bmjophth.bmj.com/content/9/1/e001702.full |
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