What is the difference between Vabysmo and Eylea?

Q: What is the difference between Vabysmo and Eylea?

Vabysmo (faricimab) targets vascular endothelial growth factor (VEGF) and angiopoietin-1, whereas Eylea (afibercept) targets VEGF and placental growth factor (PlGF). Both agents are used to treat conditions such as macular degeneration (AMD) and diabetic macular edema and are given by intravitreal injection (into the gel part of the eye).

Official answer

by Drugs.com

Vabysmo (faricimab) and Eylea (afibercept) are two eye injections used in the treatment of neovascular (wet) age-related macular degeneration (AMD) and diabetic macular edema (DME). Eylea also has additional FDA-approved uses and a higher strength formulation.

The injections are administered by intravitreal injection (into the gel-like part of the eye) by your retina eye specialist (a trained ophthalmologist). Your doctor will use a medicine to numb your eye before the injection. You will receive this injection in your doctor's office or a specialty clinic.

Vabysmo is a bispecific antibody that targets both vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2), whereas Eylea is a recombinant fusion protein that targets VEGF and placental growth factor (PlGF).

Vabysmo, approved by the FDA in 2022, is approved for two indications, while Eylea, first approved in 2011, is cleared for five specific uses (see table below). A higher strength product of afibercept called Eylea HD became available in 2023 and is FDA-approved for 3 uses.

Clinical studies have shown that Vabysmo and Eylea have similar safety profiles and that Vabysmo is non-inferior to Eylea, which means that the clinical benefits it provides are similar to those provided by Eylea.

Similar common side effects that occur with Vabysmo, Eylea and Eylea HD include: cataracts and conjunctival hemorrhage (bleeding). Other side effects are described in the table below.

Vabysmo dosing schedule for AMD / DME

After 4 initial monthly injections to stabilize your vision, Vabysmo injections are usually given every 8, 12 or 16 weeks in patients with AMD depending on how well they are responding to treatment.

In patients with DME, after 4 or 6 initial monthly eye injections, the doctor will choose a schedule of 1 to 4 months.

Eylea dosing schedule for AMD / DME

After 3 initial monthly injections, Eylea is usually given once every 8 weeks for AMD, but may be given up to every 12 weeks after 1 year of treatment in certain patients. Some patients may also receive treatment every 4 weeks, but effectiveness when compared to every 8 weeks was not seen in most patients.

After 5 initial monthly injections for DME, Eylea is usually given as an injection once every 8 weeks. Some patients may still need every 4 week dosing.

Eylea HD dosing schedules for AMD / DME

Eylea HD is usually given as an injection in the eye every 4 weeks for the first 3 months in AMD or DME, then it is administered once every 8 to 16 weeks.

Dosing for Vabysmo, Eylea and Eylea HD may vary based on your response. Your retina specialist eye doctor will determine the dosing schedule that is right for you.

Select facts - Vabysmo vs Eylea / Eylea HD

	Vabysmo	Eylea / Eylea HD
Generic name	Faricimab-svoa	Aflibercept
Company	Genentech	Regeneron
FDA approval date	2022	2011 / 2023
Drug type / class	Bispecific antibody	Recombinant fusion protein
Dosage form	Intravitreal injection (in the gel-like part of the eye)	Intravitreal injection (in the gel-like part of the eye)
Mechanism of action	VEGF and angiopoietin-2 inhibitor	Inhibits VEGF / placental growth factor (PlGF)
Indications / usage	Neovascular (wet) AMD Diabetic macular edema (DME)	Eylea Neovascular (wet) AMD Diabetic macular edema (DME) Macular edema following retinal vein occlusion Diabetic retinopathy (DR) Retinopathy of prematurity (ROP) Eylea HD Neovascular (wet) AMD Diabetic macular edema (DME) Diabetic retinopathy (DR)
Dosing schedule and administration (intravitreal injection)	Vabysmo: For detailed dosing instructions, visit: Vabysmo Monograph	Eylea / Eylea HD: For detailed dosing instructions, visit: Eylea / Eylea HD Monograph
Side effects / adverse effects	The most common adverse reaction (≥ 5%) reported in patients was: cataract conjunctival hemorrhage (bleeding)	The most common adverse reactions (≥ 3% to 5%) reported in patients were: Eylea / Eylea HD conjunctival hemorrhage (bleeding) eye pain cataract vitreous detachment vitreous (gel-like substance) floaters intraocular pressure increased Eylea HD Additional side effects (≥3%) reported in patients using Eylea HD were: ocular discomfort / eye irritation blurred vision corneal epithelium defect (injury to the outer layer of the eye) retinal hemorrhage (bleeding in the back of the eye)
Warnings and precautions	Endophthalmitis (eye infection) and retinal detachments (separation of layers of the retina) may occur following intravitreal injections. Any symptoms of endophthalmitis or retinal detachments should be reported promptly to your retinal specialist eye doctor. Increases in intraocular pressure (elevated eye pressure) have been seen within 60 minutes of an intravitreal injection. There is a potential risk of arterial thromboembolic events (ATEs) - clotting in an artery leading to stroke, heart attack or death - associated with VEGF inhibition.	Endophthalmitis (eye infection) and retinal detachments (separation of layers of the retina) may occur following intravitreal injections. Any symptoms of endophthalmitis or retinal detachments should be reported promptly to your retinal specialist eye doctor. Increases in intraocular pressure (elevated eye pressure) have been seen within 60 minutes of an intravitreal injection. There is a potential risk of arterial thromboembolic events (ATEs) - clotting in an artery leading to stroke, heart attack or death - associated with VEGF inhibition. In infants with Retinopathy of Prematurity (ROP) who receive Eylea, extended periods of ROP monitoring are needed. ROP is not an approved use for Eylea HD.

This is not all the information you need to know about Vabysmo, Eylea or Eylea HD for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

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