Faricimab (Intravitreal)

How it works

It simultaneously binds and neutralises both vascular endothelial growth factor-A and angiopoietin-2, reducing vascular leakage, neovascularisation and inflammation, and helping stabilise the retinal vasculature.

Prescribing in practice

• Intravitreal injection carries a risk of endophthalmitis and intraocular inflammation, so it must be given under aseptic conditions and patients told to report eye pain, redness or worsening vision urgently.
• It is contraindicated in active or suspected ocular or periocular infection and active intraocular inflammation.
• A transient rise in intraocular pressure can occur after injection, so perfusion of the optic nerve head and pressure should be assessed.

Monitoring

Assess intraocular pressure and optic nerve perfusion around the time of injection and review visual acuity and retinal imaging to guide the treatment interval.

Counselling the patient

• Report eye pain, increasing redness, light sensitivity, floaters or any drop in vision without delay, as these can signal infection.
• Mild eye irritation or a small bleed on the white of the eye after the injection is common and usually settles.
• Attend all follow-up appointments, as injections are given on a planned and sometimes extending schedule.

Evidence & guidelines

The TENAYA, LUCERNE, YOSEMITE and RHINE trials demonstrated non-inferior visual outcomes with faricimab and the potential for extended dosing intervals in wet AMD and diabetic macular oedema.