REVIEW article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1682311
Progress in the Treatment of Diabetic Macular Edema with Faricimab: A Review
Provisionally accepted
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Diabetic macular edema (DME), a prevalent complication of diabetic retinopathy, is a leading cause of vision loss among working-age individuals worldwide. It is characterized by chronic vascular leakage, inflammation, and disruption of the blood–retinal barrier, resulting in macular fluid accumulation. Anti-vascular endothelial growth factor A (VEGF-A) therapies, such as ranibizumab and aflibercept, have significantly improved visual outcomes; however, limitations such as frequent injections, persistent edema, and suboptimal responses continue to pose challenges in clinical practice. Faricimab is the first bispecific monoclonal antibody designed to concurrently inhibit VEGF-A and angiopoietin-2 (Ang-2), two key regulators of vascular permeability and inflammation. Through its dual-targeting mechanism, faricimab enhances vascular stability, reduces leakage, and enables extended treatment intervals. Phase III clinical trials (YOSEMITE and RHINE) have demonstrated its noninferior efficacy compared to aflibercept, with a substantial proportion of patients achieving dosing intervals up to 16 weeks. Emerging real-world data further support its effectiveness and durability, particularly in individuals refractory to conventional anti-VEGF agents. This review summarizes the current evidence regarding faricimab's molecular mechanisms, pharmacokinetic profile, clinical efficacy, real-world applications, and safety. By alleviating treatment burden and supporting individualized management, faricimab represents a promising advancement in the long-term care of DME. Future research should focus on its long-term safety, identification of response biomarkers, and integration with imaging-guided algorithms to refine personalized treatment strategies.
Keywords: diabetic macular edema, Faricimab, VEGF-A, Angiopoietin-2, BispecificAntibody, extended dosing, clinical trials
Received: 08 Aug 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Gao, Liu, Zeng, Wu and Duan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingxue Gao, 1689403348@qq.com
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