Faricimab (Vabysmo) is a bispecific antibody targeting vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2). It is indicated for the treatment of neovascular (wet) age-related macular degeneration (nAMD), diabetic macular edema (DME), and macular edema secondary to retinal vein occlusion (RVO).
What Are the Side Effects of Faricimab (Vabysmo)?
Ocular Reactions
Cataract (15%, particularly prominent in patients with DME).
Subconjunctival hemorrhage (8%).
Vitreous detachment (5%).
Vitreous floaters (4%).
Increased intraocular pressure (4%).
Eye pain (3%).
Systemic Reactions
Retinal pigment epithelium tear (3% in patients with nAMD).
Mild intraocular inflammation (e.g., iridocyclitis, incidence of 2%).
Severe Side Effects of Faricimab (Vabysmo) That Require Vigilance
Endophthalmitis and Retinal Detachment
Risk: Similar to all intravitreal injection drugs, it may cause infectious or non-infectious endophthalmitis.
Symptoms: Sudden vision loss, red eyes, eye pain, and photophobia.
Management: The drug must be discontinued immediately, and antibiotic/anti-inflammatory treatment should be administered; surgical intervention may be required if necessary.
Retinal Vasculitis/Vascular Occlusion
Risk: Post-marketing surveillance reports indicate that it may be accompanied by severe intraocular inflammation.
Symptoms: Painless vision loss and visual field defects.
Management: Permanently discontinue the drug and refer the patient to a retinal specialist.
Arterial Thromboembolic Events
Mechanism: VEGF inhibition may increase the risk of thrombosis.
High-Risk Population: Patients with a history of cardiovascular and cerebrovascular diseases should use the drug with caution.
Acute Increase in Intraocular Pressure
Characteristic: Transient increase in intraocular pressure may occur within 60 minutes after injection.
Monitoring: After injection, it is necessary to check optic nerve perfusion or measure intraocular pressure with a tonometer.
Precautions for Administration of Faricimab (Vabysmo)
Contraindications
Active ocular or periocular infections.
Active intraocular inflammation (e.g., uveitis).
Hypersensitivity to faricimab or its excipients.
Special Populations
Pregnancy: Animal studies have shown a risk of miscarriage; women of childbearing age must use contraception for 3 months after the last dose.
Elderly Patients: No dosage adjustment is required for patients aged ≥65 years, but enhanced monitoring is necessary.
Patient Education
Avoid rubbing the eyes or swimming within 24 hours after injection.
Seek medical attention immediately if sudden vision loss, eye pain, or flashes of light occur.
