The real-world impact of faricimab on clinic capacityA Roche-sponsored symposiumThis symposium is organized and funded by Hoffmann-La Roche Ltd and will contain information on Hoffmann-La Roche Ltd products.Vabysmo ▼(faricimab) 120 g/mL solution for injection is indicated for the treatment of adult patients with neovascular age-related macular degeneration (nAMD), visual impairment due to diabetic macular edema (DME), and visual impairment due to macular edema secondary to retinal vein occlusion (RVO).Ficha técnica disponible en el stand. The SmPC is available at the booth. ▼Este medicamento está sujeto a seguimiento adicional, es prioritaria la notificación de sospechas de reacciones adversas asociadas a este medicamento. ▼This medicinal product is subject to additional monitoring in EU countries. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions. Please report adverse reactions via the medinfo.roche.com website or via their national reporting system. © 2024 F. Hoffmann-La Roche Ltd | M-XX-00018557 | Date of preparation: September 2024Make a change for good
Welcome and introductionsDavid WongChair
DME: diabetic macular edema; EU: European Union; nAMD: neovascular age-related macular degeneration; RVO: retinal vein occlusion; SmPC: Summary of Product Characteristics.1. F Hoffmann-La Roche. Vabysmo (faricimab) Summary of Product Characteristics. Available here (accessed August 2024). •This scientific meeting is sponsored by F. Hoffmann-La Roche Ltd. It is intended for healthcare professionals based in Europe This program is not affiliated with or endorsed by EURETINA•This is a non-promotional meeting intended to facilitate transparent scientific exchange regarding developments in medical research and disease management•Prescribing information may vary depending on the applicable approval in the respective country. Therefore, before prescribing any product, always refer to applicable local materials such as the prescribing information and/or the SmPC•The real-world cases about faricimab presented in this meeting are representative of routine, clinical practice and may deviate from the dosing posology recommendations outlined in your local SmPC. These cases do not intend to promote the use of faricimab outside of the SmPC and are presented for discussion purposes only•Faricimab▼ is approved for the treatment of nAMD, DME and RVO in the EU.1 Faricimab is not currently approved in the EU for use outside these indications. Status as of August 2024•▼ This medicinal product is subject to additional monitoring, healthcare professionals are asked to report any suspected adverse reaction and may do so via the medinfo.roche.com website or via their national reporting system •▼ Este medicamento está sujeto a seguimiento adicional, es prioritaria la notificación de sospechas de reacciones adversas asociadas a este medicamentoDisclaimer
DME: diabetic macular edema; EU: European Union; IVT: intravitreal; nAMD: neovascular age-related macular degeneration; Q4/8/12/16W: every 4/8/12/16 weeks; RVO: retinal vein occlusion; SmPC: Summary of Product Characteristics; T&E: treat and extend.1. F Hoffmann-La Roche. Vabysmo (faricimab) Summary of Product Characteristics. Available here (accessed August 2024). •Real-world cases about faricimab presented in this symposium are representative of routine, clinical practice and may deviate from the dosing posology recommendations outlined in the EU SmPC. These cases do not intend to promote the use of faricimab outside of the SmPC and are presented for discussion purposes only •For prescribing and safety profile information about faricimab, please refer to your local SmPCOff-label disclaimerFaricimab 6.0 mg administered by IVT injection Q4W for the first 4 loading dosesThereafter, treatment is individualized using a T&E approach in which the dosing may be extended based on anatomic and/or visual outcome assessments at the physician's discretion up to Q16W in increments of 4 weeksEU SmPC recommended posology for DME1Faricimab 6.0 mg administered by IVT injection Q4W for the first 4 loading dosesThereafter, anatomic and/or visual outcome assessments are recommended at Weeks 20 and/or 24 to individualize treatment. At the physician's discretion, dosing Q16W should be considered in absence of disease activity and Q12W or Q8W if disease activity is present. If anatomic and/or visual outcomes change, the treatment interval should be adjusted accordinglyEU SmPC recommended posology for nAMD1Faricimab 6.0 mg administered by IVT injection Q4W; 3 or more consecutive monthly injections might be neededThereafter, treatment is individualized using a T&E approach in which the dosing may be extended based on anatomic and/or visual outcome assessments at the physician's discretion in increments of up to 4 weeksEU SmPC recommended posology for RVO1
Robin HamiltonMoorfields Eye Hospital NHS Foundation Trust London, UKJorge Ruiz-MedranoUniversity Hospital Puerta de Hierro Majadahonda, Madrid, Spain Our facultyDavid Wong (Chair)St. Michael's Hospital, Toronto, CanadaRomi ChhabraManchester Royal Eye Hospital, Manchester, UK
DisclosuresRobin HamiltonConsultant/contractor Bayer, F Hoffmann La-RocheFinancial supportBayer, F Hoffmann La-RocheRecipient Allergan/AbbVie, Alimera, Bayer, Novartis, F Hoffmann La-Roche and TevaJorge Ruiz-MedranoConsultancyAbbVie and F Hoffmann La-RocheConsultancyAbbVie, Alcon, Apellis, Bausch Health, Bayer, Biogen, Novartis, Regeneron, Ripple Therapeutics, F HoffmannLa-Roche and Zeiss Grant supportBayer, Novartis andF Hoffmann La-RocheDavid WongConsultancyAlimera Sciences, Bayer, Novartis and Roche Products Ltd. Principal InvestigatorNovartis, Bayer and Roche Products Ltd.Romi Chhabra
The growing issue of managing clinic capacityDavid Wong
26NHS: National health Service.1. Le Monde. Available here (accessed August 2024); 2. The Mirror. Available here (accessed August 2024); 3. ConSalud.es. Available here (accessed August 2024); 4. The Guardian. Available here (accessed August 2024); 5. LaTercera. Available here (accessed August 2024);6. Modaengafas.com. Available here (accessed August 2024).Clinic capacity constraints are an issue faced worldwide...1345...and it is only going to get worse!
Loewenstein A, et al. Eye (Lond) 2023;37(16):3351–3359.There are several benefits associated with improving clinic capacityStreamline and personalize the patient experienceReduce treatment burden and optimize clinic resourcesEnable more equitable accessto careEnsure optimal health outcomes
Speaker’s own clinical experience and opinion.Various stakeholders benefit from improving clinic capacityClinic staffHospital managers and payers experiencing heavy treatment burdentreating patients inbusy clinicsPatients and caregiversmanaging limited resources
Improving access to durable therapies will allow us to make a changefor good
Faricimab: the first intraocular bispecific antibody1Modified FcReduces systemic exposure3Reduces inflammatory potential3Anti–VEGF-A FabReduces vascular leakage2Inhibits neovascularization2Anti–Ang-2 FabStabilizes vessels2Reduces vascular leakage2Reduces inflammation31 molecule with 2 signalling pathway targets for durable efficacyTargeting multiple signalling pathways with faricimab may result in durable efficacy when treating retinal diseases2CrossMAb molecule representative of faricimab.2Ang-2: angiopoietin-2; Fab: fragment antigen binding; Fc: fragment crystallisable; MAb: monoclonal antibody; VEGF-A: vascular endothelial growth factor A.Faricimab molecule image reprinted from Sahni J, et al. Ophthalmology 2019;126(8):1155–1170, Copyright (2019), with permission from the American Academy of Ophthalmology.1. Regula JT, et al. EMBO Mol Med 2016;8(11):1265–1288, with erratum in Regula JT, et al. EMBO Mol Med 2019;11(5):e10666; 2. Panos GD, et al. Drug Des Devel Ther 2023;17:2861–2873; 3. Sahni J, et al. JAMA Ophthalmol 2020;138(9):955–963. .
ARVO: Association for Research in Vision and Ophthalmology.1. Wong TY, et al. Ophthalmology 2024;131(6):708–723; 2. Khanani AM, et al. Ophthalmology 2024:131(8):914–926; 3. Tabano D, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 4. Varma D, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 5. Borkar D, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 6. Reynolds R, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 7. Khanani AM, et al. Presented at the Angiogenesis, Exudation and Degeneration 2023. Virtual Congress, 10–11 February 2023; 8. Singh R, et al. Presented at the 48th Brazilian Retina and Vitreous Society Congress, 18–21 April 2024, Campinas, Brazil; 9. Sim SY, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 10. Babiker S, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 11. Patel S, et al. Presented at the ARVO Annual Meeting, 5–9 May 2024, Seattle, Washington, USA; 12. Yuan AE, et al. Presented at the 47th Macular Society Annual Meeting, 7–10 February 2024, Palm Springs, California, USA; 13. Momenaei B, et al. Ophthalmol Retina 2024;8(3):311–313.Outcomes reported with faricimab in clinical practice are aligned with those from clinical trials1–13Significant improvementsin VA3–6Significant drying and anatomic improvements3,5Strong durability, leading to extended treatment intervals3–6,9,10A safety profile aligned with thePhase III trials1–6,11–13
How do outcomes with faricimabimpact clinic capacity?
Today we will demonstrate the change faricimab can make on alleviating clinic capacity constraints and how this directly impacts:Clinic staffHospital managers and payers Patients and caregivers
Robin HamiltonJorge Ruiz-MedranoRomi ChhabraToday we will demonstrate the change faricimab can make on alleviating clinic capacity constraints and how this directly impacts:Clinic staffHospital managers and payers Patients and caregivers
Alleviating clinic capacity challenges with faricimabRomi Chhabra, Jorge Ruiz-Medrano, Robin Hamiltonand David Wong (Chair)
Real-world impactof faricimab on clinic staffRomi ChhabraThe Manchester RoyalEye Hospital experienceThe information in this presentation is exclusively based on the speaker's personal clinical experience at the Manchester Royal Eye Hospital during the period between 28 November 2022 and 7 February 2023. It is intended for informational purposes only, as an example of real-world experience with faricimab in this hospital.
PATIENTS &CAREGIVERSCLINICSTAFFPAYERS &MANAGERSHCP: healthcare professional.Speaker’s own clinical experience and opinion.A look into the retinal clinic at Manchester Royal Eye Hospital~180–200 patientsseen per daySuboptimal clinic capacity negatively impactsHCP wellbeing and the delivery of patient care •One-stop eye clinic•Runs across 4 sites: central and 3 community clinics)Patient overviewClinic set-upChallenges•Significant injection burden•Weekly costly Saturday clinics•Staff overbooked
PATIENTS &CAREGIVERSCLINICSTAFFPAYERS &MANAGERS*According to the Manchester Royal Eye Hospital protocol for faricimab in nAMD.nAMD: neovascular age-related macular degeneration; NICE: National Institute for Health and Care Excellence; Q6/7/8W: every 6/7/8 weeks; TA: technology appraisal; VEGF: vascular endothelial growth factor.1. Speaker’s own clinical experience and opinion; 2. NICE. TA800. Available here (accessed August 2024); 3. NICE. TA799. Available here (accessed August 2024).© NICE 2022 Faricimab for treating wet age-related macular degeneration. Available from https://www.nice.org.uk/guidance/ta800. © NICE 2022 Faricimab for treating diabetic macular oedema. Available from https://www.nice.org.uk/guidance/ta799. All rights reserved. Subject to Notice of rights. NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.Prospective audit at Manchester Royal Eye Hospital:Real-world effectiveness and safety of faricimab1Faricimab reimbursement2,3June 202228 November 202212 January 2024Data cut-off1Patient cohort1•Patients with any type of nAMD (N=200)•Patients with sub-optimal response to previous anti-VEGFs•Treatment with faricimab:•No disease activity → treatment was extended*o4x loading doses for patients on prior ≤Q4–7W dosingoMatched treatment interval for patients on prior ≥Q8W dosing)Treatment protocol1Study start1
PATIENTS &CAREGIVERSCLINICSTAFFPAYERS &MANAGERS*For the prior 12 months before switching treatment to faricimab.BCVA: best-corrected visual acuity; ETDRS: Early Treatment Diabetic Retinopathy Study; IQR: interquartile range; SD: standard deviation.Speaker’s own clinical experience and opinion.Baseline characteristics and demographicsBaseline characteristicsTreatment-experienced patients (N=200)Mean age, years (range)79.53 (58–97)Sex, n (%)Female patients64.6Mean length of treatment pre-switch, months (IQR)49.0 (19–72)Mean (± SD) number of injections pre-switch, % 35.70 (27.5)Mean (± SD) treatment interval pre-switch, weeks*5.20 (1.33)Mean BCVA pre-switch, ETDRS letters64.04Breakdown of prior treatment pre-switch, % Switched from aflibercept88.0 Switched from ranibizumab10.0 Switched from brolucizumab2.0Mean length of follow-up post-switch, weeks (range)50.28 (36.9–56.7)
