Efficacy, durability, and safety of intravitreal faricimab up to every 16 weeks for neovascular age-related macular degeneration (TENAYA and LUCERNE): two randomised, double-masked, phase 3, non-inferiority trials

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Jeffrey S. Heier
  • Arshad M. Khanani
  • Carlos Quezada Ruiz
  • Karen Basu
  • Philip J. Ferrone
  • Christopher Brittain
  • Marta S. Figueroa
  • Hugh Lin
  • Frank G. Holz
  • Vaibhavi Patel
  • Timothy Y.Y. Lai
  • David Silverman
  • Carl Regillo
  • Balakumar Swaminathan
  • Francesco Viola
  • Chui Ming Gemmy Cheung
  • Tien Y. Wong
  • Ashkan Abbey
  • Elmira Abdulaeva
  • Prema Abraham
  • Alfredo Adan Civera
  • Hansjurgen Agostini
  • Arturo Alezzandrini
  • Virgil Alfaro
  • Arghavan Almony
  • Lebriz Altay
  • Payam Amini
  • Andrew Antoszyk
  • Etelka Aradi
  • Luis Arias
  • Jennifer Arnold
  • Riaz Asaria
  • Sergei Astakhov
  • Yury Astakhov
  • Carl C. Awh
  • Chandra Balaratnasingam
  • Sanjiv Banerjee
  • Caroline Baumal
  • Matthias Becker
  • Rubens Belfort
  • Galina Bratko
  • William Z. Bridges
  • Jamin Brown
  • David M. Brown
  • Maria Budzinskaya
  • Sylvia Buffet
  • Stuart Burgess
  • Iksoo Byon
  • Michael Larsen
  • Sørensen, Torben Lykke
  • TENAYA and LUCERNE Investigators

Background: Faricimab is a bispecific antibody that acts through dual inhibition of both angiopoietin-2 and vascular endothelial growth factor A. We report primary results of two phase 3 trials evaluating intravitreal faricimab with extension up to every 16 weeks for neovascular age-related macular degeneration (nAMD). Methods: TENAYA and LUCERNE were randomised, double-masked, non-inferiority trials across 271 sites worldwide. Treatment-naive patients with nAMD aged 50 years or older were randomly assigned (1:1) to intravitreal faricimab 6·0 mg up to every 16 weeks, based on protocol-defined disease activity assessments at weeks 20 and 24, or aflibercept 2·0 mg every 8 weeks. Randomisation was performed through an interactive voice or web-based response system using a stratified permuted block randomisation method. Patients, investigators, those assessing outcomes, and the funder were masked to group assignments. The primary endpoint was mean change in best-corrected visual acuity (BCVA) from baseline averaged over weeks 40, 44, and 48 (prespecified non-inferiority margin of four letters), in the intention-to-treat population. Safety analyses included patients who received at least one dose of study treatment. These trials are registered with ClinicalTrials.gov (TENAYA NCT03823287 and LUCERNE NCT03823300). Findings: Across the two trials, 1329 patients were randomly assigned between Feb 19 and Nov 19, 2019 (TENAYA n=334 faricimab and n=337 aflibercept), and between March 11 and Nov 1, 2019 (LUCERNE n=331 faricimab and n=327 aflibercept). BCVA change from baseline with faricimab was non-inferior to aflibercept in both TENAYA (adjusted mean change 5·8 letters [95% CI 4·6 to 7·1] and 5·1 letters [3·9 to 6·4]; treatment difference 0·7 letters [−1·1 to 2·5]) and LUCERNE (6·6 letters [5·3 to 7·8] and 6·6 letters [5·3 to 7·8]; treatment difference 0·0 letters [–1·7 to 1·8]). Rates of ocular adverse events were comparable between faricimab and aflibercept (TENAYA n=121 [36·3%] vs n=128 [38·1%], and LUCERNE n=133 [40·2%] vs n=118 [36·2%]). Interpretation: Visual benefits with faricimab given at up to 16-week intervals demonstrates its potential to meaningfully extend the time between treatments with sustained efficacy, thereby reducing treatment burden in patients with nAMD. Funding: F Hoffmann-La Roche.

OriginalsprogEngelsk
TidsskriftLancet
Vol/bind399
Udgave nummer10326
Sider (fra-til)729-740
Antal sider12
ISSN0140-6736
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
We thank the patients who participated in these trials and their families, the investigators, and staff at all the TENAYA and LUCERNE clinical sites, and the members of the independent data and safety monitoring committee. We thank Aaron Osborne for his contribution to the design of the TENAYA and LUCERNE trials. F Hoffmann-La Roche (Basel, Switzerland) provided support for the study and participated in the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the article for publication. Funding was provided by F Hoffmann-La Roche for third-party writing assistance, which was provided by Dinakar Sambandan of Envision Pharma Group. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.

Funding Information:
JSH reports support from Genentech/Roche for the present manuscript; grants from Apellis, AsclepiX, Bayer, Gyroscope, Hemera, Iveric Bio, Kanghong, Kodiak, NGM, Notal Vision, Novartis, Regeneron, Regenxbio, and Stealth, outside the submitted work; and consulting fees from Apellis, AsclepiX, Bayer, Gyroscope, Hemera, Iveric Bio, Kanghong, Kodiak, NGM, Notal Vision, Novartis, Regeneron, Regenxbio, and Stealth. AMK reports grants or contracts to institution from Adverum, Allergan, Chengdu Kanghong, Genentech, Graybug, Novartis, Ophthea, Regenxbio, and Roche, outside the submitted work; consulting fees from Adverum, Allergan, Chengdu Kanghong, Genentech, Graybug, Novartis, Ophthea, Regenxbio, and Roche, outside the submitted work; payment or honoraria for lectures, presentations, or speaker bureaus from Allergan, Genentech, and Novartis, outside the submitted work; and has served on advisory boards for Adverum, Allergan, Chengdu Kanghong, Genentech, Novartis, Ophthea, Regenxbio, and Roche. CQR is an employee of Genentech and reports owning stocks in Roche. KB is an employee of Roche Products (Ireland). PJF reports patient care grants to institution (Vitreoretinal Consultants of New York) for various national clinical trials from Alkeus, Apellis, Chengdu Kanghong, Genentech, Gyroscope, Iveric Bio, Kodiak, NGM, and Regeneron; has served on advisory boards for Allergan and Genentech; and is the president of the American Association of Retinal Specialists (unpaid). CB is an employee of Genentech, and reports owning stocks in Roche. MSF reports consulting fees from Alcon, Bayer, Novartis, Roche, and Zeiss. HL is an employee of Genentech, and has received stock from Genentech/Roche as an employee; has received support from Genentech/Roche to attend meetings as an employee; and is a coauthor on patent application WO202123804 involving the PTI algorithm. FGH reports research grants or contracts to institution from Bayer, Bioeq/Formycon, Kanghong, Novartis, and Roche/Genentech; consulting fees from Bayer, Kanghong, Novartis, and Roche/Genentech; and payment or honoraria for lectures, presentations, or speaker bureaus from Bayer and Novartis. VP is an employee of F Hoffmann-La Roche (UK). TYYL reports grants or contracts to institution from Bayer, Chengdu Kanghong, and Novartis, outside the submitted work; consulting fees from Bayer, Boehringer Ingelheim, Novartis, Oculis, and Roche, outside the submitted work; and payment or honoraria for lectures, presentations, or speaker bureaus from Bayer, Chengdu Kanghong, Novartis, and Roche, outside the submitted work. DS is an employee of F Hoffmann-La Roche (UK); owns stock and stock options in Roche; and is a coauthor on patent application WO202123804 involving the PTI algorithm. CR reports research support from Allergan, Kodiak, Novartis, and Regeneron, outside the submitted work; and consulting fees from Allergan, Genentech, Kodiak, and Novartis, outside the submitted work. BS is an employee of F Hoffmann-La Roche. FV reports consulting fees from Bayer and Roche; payments for expert testimony from Bayer and Roche; and payments for participation on advisory boards for Bayer and Roche. CMGC reports grants or contracts from Bayer, Boehringer Ingelheim, Novartis, and Topcon, outside the submitted work; consulting fees from Novartis and Roche, outside the submitted work; speaker fees from Allergan, Bayer, Novartis, Roche, Topcon, and Zeiss, outside the submitted work; and support for travel to meetings from Bayer and Topcon. TYW reports clinical trial grants from Aldropika, Allergan, Bayer, Boehringer Ingelheim, Eden Ophthalmic, Genentech, Iveric Bio, Merck, Novartis, Oxurion (ThromboGenics), Roche, Samsung, Shanghai Henlius, and Zhaoke, outside the submitted work; consulting fees from Aldropika, Allergan, Bayer, Boehringer Ingelheim, Eden Ophthalmic, Genentech, Iveric Bio, Merck, Novartis, Oxurion (ThromboGenics), Roche, Samsung, Shanghai Henlius, and Zhaoke, outside the submitted work; payment or honoraria from Allergan, Bayer, Boehringer Ingelheim, Eden Ophthalmic, Genentech, Iveric Bio, Merck, Novartis, Oxurion (ThromboGenics), Roche, Samsung, Shanghai Henlius, and Zhaoke, outside the submitted work; support for travel from Aldropika, Allergan, Bayer, Boehringer Ingelheim, Eden Ophthalmic, Genentech, Iveric Bio, Merck, Novartis, Oxurion (ThromboGenics), Roche, Samsung, Shanghai Henlius, and Zhaoke; and has served on advisory boards of Aldropika, Allergan, Bayer, Boehringer Ingelheim, Eden Ophthalmic, Genentech, Iveric Bio, Merck, Novartis, Oxurion (ThromboGenics), Roche, Samsung, Shanghai Henlius, and Zhaoke.

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© 2022 Elsevier Ltd

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