Experts Warn Against Faricimab Rechallenge Post-Inflammation

TOPLINE:

Patients who develop mild intraocular inflammation after receiving faricimab may experience severe, irreversible vision loss when rechallenged with the drug.

METHODOLOGY:

• Researchers reported on three patients (four eyes) treated at the University of Nebraska Medical Center, Omaha, Nebraska, who developed a mild anterior chamber reaction after receiving intravitreal faricimab.
• The patients were treated with faricimab for either neovascular age-related macular degeneration (two eyes) or diabetic macular edema (two eyes).
• Despite prior development of intraocular inflammation, the same biologic was readministered to all patients.
• Analysis focused on the clinical signs and symptoms and clinical course of patients diagnosed with occlusive retinal vasculitis following rechallenge with faricimab.

TAKEAWAY:

• Of the four eyes that showed mild intraocular inflammation after administration of faricimab, three developed occlusive retinal vasculitis upon rechallenge.
• Profound damage to vision that could not be resolved even with systemic or topical steroids was observed in the three eyes.
• No repeated adverse events occurred despite restarting intravitreal faricimab injections in the single eye that did not develop occlusive retinal vasculitis following rechallenge.

IN PRACTICE:

“Given these observations, caution is advisable prior to rechallenging with the same biologic after the development of even mild [intraocular inflammation],” the authors of the case series wrote.

SOURCE:

The study was led by Will Bruening of the Truhlsen Eye Center at the University of Nebraska Medical Center. It was published online on January 23, 2025, in JAMA Ophthalmology.

LIMITATIONS:

No limitations were discussed for this study.

DISCLOSURES:

One author was supported by an award from the National Institutes of Health, the Knights Templar Eye Foundation career starter grant and competitive renewal, and a Physician Scientist award and startup funds from the University of Nebraska Medical Center. This author reported receiving grants from certain institutions, and another author disclosed serving as a consultant for certain institutions and pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.