TY - JOUR

T1 - TENAYA and LUCERNE

T2 - 2-Year Results from the Phase 3 nAMD Trials of Faricimab with Treat-and-Extend Dosing in Year 2

AU - Khanani, Arshad M

AU - Kotecha, Aachal

AU - Chang, Andrew

AU - Chen, Shih-Jen

AU - Chen, Youxin

AU - Guymer, Robyn

AU - Heier, Jeffrey S

AU - Holz, Frank G

AU - Iida, Tomohiro

AU - Ives, Jane A

AU - Lim, Jennifer I

AU - Lin, Hugh

AU - Michels, Stephan

AU - Quezada Ruiz, Carlos

AU - Schmidt-Erfurth, Ursula

AU - Silverman, David

AU - Singh, Rishi

AU - Swaminathan, Balakumar

AU - Willis, Jeffrey R

AU - Tadayoni, Ramin

AU - TENAYA and LUCERNE Investigators

A2 - Sørensen, Torben Lykke

N1 - Copyright © 2024. Published by Elsevier Inc.

PY - 2024/2/19

Y1 - 2024/2/19

N2 - PURPOSE: To evaluate the 2-year efficacy, durability, and safety of the bispecific antibody, faricimab, which inhibits both angiopoietin-2 and vascular endothelial growth factor-A.DESIGN: TENAYA (NCT03823287) and LUCERNE (NCT03823300) were identically designed, randomized, double-masked, active comparator-controlled phase 3 noninferiority trials across 271 sites worldwide.PARTICIPANTS: Treatment-naïve patients with neovascular age-related macular degeneration (nAMD) aged ≥ 50 years.METHODS: Randomized (1:1) to intravitreal faricimab 6.0 mg up to every 16 weeks (Q16W) or aflibercept 2.0 mg every 8 weeks (Q8W). Faricimab fixed dosing based on protocol-defined disease activity at weeks 20 and 24 up to week 60, followed up to week 108 by a treat-and-extend-based personalized treatment interval regimen.MAIN OUTCOME MEASURES: Efficacy analyses included change in best-corrected visual acuity (BCVA) from baseline at 2 years (averaged over weeks 104, 108, and 112) and proportion of patients on Q16W, every 12 weeks (Q12W), and Q8W dosing at week 112 in the intention-to-treat population. Safety analyses included ocular adverse events (AEs) in the study eye through study end at week 112 in patients who received ≥ 1 dose of study treatment.RESULTS: Of 1326 patients treated across the trials, 1113 (83.9%) completed study treatment (n = 555 faricimab and n = 558 aflibercept). BCVA change from baseline at 2 years was comparable between faricimab and aflibercept in TENAYA (adjusted mean change [95% confidence interval (CI)] +3.7 letters [+2.1 to +5.4] and +3.3 letters [+1.7 to +4.9], respectively; mean difference [95% CI] 0.4 letters [-1.9 to +2.8]) and in LUCERNE (adjusted mean change [95% CI] +5.0 letters [+3.4 to +6.6] and +5.2 [+3.6 to +6.8], respectively; mean difference [95% CI] -0.2 letters [-2.4 to +2.1]). At week 112 in TENAYA and LUCERNE respectively, 59.0% and 66.9% achieved Q16W faricimab dosing, increasing from year 1, and 74.1% and 81.2% achieved ≥ Q12W dosing. Ocular AEs in the study eye were comparable between faricimab and aflibercept in TENAYA (55.0% and 56.5% of patients) and LUCERNE (52.9% and 47.5% of patients) through week 112.CONCLUSIONS: Treat-and-extend-based faricimab treatment based on nAMD disease activity maintained vision gains through year 2 with most patients achieving extended dosing intervals.

AB - PURPOSE: To evaluate the 2-year efficacy, durability, and safety of the bispecific antibody, faricimab, which inhibits both angiopoietin-2 and vascular endothelial growth factor-A.DESIGN: TENAYA (NCT03823287) and LUCERNE (NCT03823300) were identically designed, randomized, double-masked, active comparator-controlled phase 3 noninferiority trials across 271 sites worldwide.PARTICIPANTS: Treatment-naïve patients with neovascular age-related macular degeneration (nAMD) aged ≥ 50 years.METHODS: Randomized (1:1) to intravitreal faricimab 6.0 mg up to every 16 weeks (Q16W) or aflibercept 2.0 mg every 8 weeks (Q8W). Faricimab fixed dosing based on protocol-defined disease activity at weeks 20 and 24 up to week 60, followed up to week 108 by a treat-and-extend-based personalized treatment interval regimen.MAIN OUTCOME MEASURES: Efficacy analyses included change in best-corrected visual acuity (BCVA) from baseline at 2 years (averaged over weeks 104, 108, and 112) and proportion of patients on Q16W, every 12 weeks (Q12W), and Q8W dosing at week 112 in the intention-to-treat population. Safety analyses included ocular adverse events (AEs) in the study eye through study end at week 112 in patients who received ≥ 1 dose of study treatment.RESULTS: Of 1326 patients treated across the trials, 1113 (83.9%) completed study treatment (n = 555 faricimab and n = 558 aflibercept). BCVA change from baseline at 2 years was comparable between faricimab and aflibercept in TENAYA (adjusted mean change [95% confidence interval (CI)] +3.7 letters [+2.1 to +5.4] and +3.3 letters [+1.7 to +4.9], respectively; mean difference [95% CI] 0.4 letters [-1.9 to +2.8]) and in LUCERNE (adjusted mean change [95% CI] +5.0 letters [+3.4 to +6.6] and +5.2 [+3.6 to +6.8], respectively; mean difference [95% CI] -0.2 letters [-2.4 to +2.1]). At week 112 in TENAYA and LUCERNE respectively, 59.0% and 66.9% achieved Q16W faricimab dosing, increasing from year 1, and 74.1% and 81.2% achieved ≥ Q12W dosing. Ocular AEs in the study eye were comparable between faricimab and aflibercept in TENAYA (55.0% and 56.5% of patients) and LUCERNE (52.9% and 47.5% of patients) through week 112.CONCLUSIONS: Treat-and-extend-based faricimab treatment based on nAMD disease activity maintained vision gains through year 2 with most patients achieving extended dosing intervals.

U2 - 10.1016/j.ophtha.2024.02.014

DO - 10.1016/j.ophtha.2024.02.014

M3 - Journal article

C2 - 38382813

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

ER -