IMPACT OF FARICIMAB VERSUS AFLIBERCEPT ON EPIRETINAL MEMBRANE FORMATION OVER 2 YEARS IN PATIENTS WITH DIABETIC MACULAR EDEMA IN THE PHASE 3 YOSEMITE AND RHINE TRIALS

Purpose: To assess the effects of faricimab versus aflibercept on epiretinal membrane (ERM) formation in eyes with diabetic macular edema (DME). Methods: Post hoc analysis of phase 3 YOSEMITE/RHINE trial data in eyes with DME receiving faricimab Q8W, faricimab treat-and-extend (T&E; up to Q16W depending on central subfield thickness [CST] and best-corrected visual acuity [BCVA]), or aflibercept Q8W for 100 weeks. Results: ERMs developed in 3.8% (23/602) of eyes treated with faricimab Q8W, 5.1% (31/608) with faricimab T&E, and 7.6% (45/590) with aflibercept Q8W at 100 weeks. ERMs were less likely with faricimab Q8W versus aflibercept Q8W (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.29–0.81, P = 0.0055). Mean (SD) BCVA at 100 weeks in eyes with and without ERMs were 69.2 (13.6) letters [20/40 Snellen] versus 73.8 (13.1) [20/40 Snellen], respectively; mean (SD) CSTs were 315.8 (99.2) vs. 274.6 (74.1) µm. Faricimab T&E dosing intervals were extended ≥ Q12W in 79.7% of eyes without ERMs versus 50.0% with ERMs. Conclusion: Risk of ERMs was 52% lower with faricimab Q8W versus aflibercept Q8W over 100 weeks in eyes with DME, suggesting a potential role for faricimab in reducing pre-retinal fibrotic proliferation. Results may help inform physician/patient decision-making when initiating intravitreal therapy.