Matthew Starr, MD
Assistant Professor of Ophthalmology
Mayo Clinic
Dr. John Wells from the Palmetto Retina Center provided the two year results of the YOSEMITE and RHINE trials at this year’s Angiogenesis meeting. The initial 1 year results from these two trials (which evaluated faricimab vs aflibercept in patients with DME) reported that faricimab was noninferior to aflibercept in regards to visual acuity at 1 year. In both trials, patients were randomized to either faricimab every 8 weeks, personalized faricimab treatment, or aflibercept every 8 weeks (each after an initial loading dose every 4 weeks). In the personalized faricimab arm, the treatment could be extended up to 4 weeks at a time (not extending past 16 week intervals) as long as the vision and CST were stable.
The stability of faricimab at one year was carried over into the second year in both studies. After the first year nearly 50% of eyes in the personalized arm were on a 16 week interval and this number increased to nearly 65% at year 2, with nearly 80% on at least a 12 week interval in the personalized faricimab arm. Although there were no CST differences at year 2 between aflibercept and faricimab, CST reduction occurred faster in the faricimab arms compared to aflibercept and more faricimab treated eyes had no intraretinal fluid compared to aflibercept treated eyes at year 2.
Most importantly, at year 2 there were no safety signals seen in the faricimab arm with low rates of intraocular inflammation seen in all 3 arms with no cases of retinal vasculitis. Certainly we are all eagerly awaiting the arrival of faricimab to help treat our patients with both DME as well as neovascular AMD in light of its recent FDA approval.
