faricimab

Faricimab is a humanized bispecific monoclonal antibody that inhibits both vascular endothelial growth factor A (VEGF-A) and Angiopoietin-2 (Ang-2). It is developed by Genentech, a subsidiary of Roche, and is administered by intravitreal injection to treat retinal diseases driven by abnormal blood vessel growth and leakage.

In ophthalmology, faricimab targets neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). Its dual mechanism aims to both suppress pathological angiogenesis (VEGF-A) and improve vascular stability (Ang-2), potentially reducing edema and inflammation.

Clinical trials have shown favorable results. In phase 3 studies for nAMD, the TENAYA and LUCERNE trials demonstrated noninferiority to aflibercept in improving visual acuity, with many patients able to extend dosing intervals to 12 to 16 weeks after loading doses. For DME, phase 3 programs reported comparable efficacy to standard anti-VEGF therapy, with evidence supporting extended treatment intervals for some patients.

Dosing regimens are individualized. After three initial monthly injections, subsequent injections may be spaced longer (up to every 16 weeks) depending on disease activity and treatment response. Safety profiles are generally consistent with other intravitreal anti-VEGF therapies, with common ocular adverse events such as conjunctival hemorrhage, eye pain, and transient increases in intraocular pressure; systemic adverse events have not shown an increased risk compared with comparators.

Brand name Vabysmo is approved for nAMD and DME in multiple regions. Faricimab represents an alternative for patients where extended dosing intervals are desirable or where dual-pathway inhibition offers clinical benefit.