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Article

Controversies in Care: The Evidence That Ang-2 Suppression Confers a Clinical Benefit

Is faricimab’s efficacy and extended durability due to its Ang-2 inhibiting properties, or simply the effect of a larger anti-VEGF dose?

By: Michael Colucciello, MD, Arshad M. Khanani, MD, MA, FASRS, Jennifer I. Lim, MD, FARVO, FASRS

Retinal Physician January 1, 2025 Vol 22, Issue January/February 2025 Page(s): 22-26

5 Key Takeaways

1

Faricimab is a bispecific antibody that inhibits both Ang-2 and VEGF-A, approved for retinal diseases based on phase 3 trial results.
2

The RUBY study found no additional visual benefit from combining Ang-2 inhibitor nesvacumab with aflibercept in diabetic macular edema.
3

Elevated Ang-2 levels in retinal diseases like nAMD and DME suggest that Ang-2 inhibition could enhance anti-VEGF therapy efficacy.
4

Despite the benefits of anti-VEGF treatments, many patients still show residual disease activity, indicating the need for alternative therapies.
5

The contribution of Ang-2 suppression to clinical outcomes in retinal diseases remains uncertain, with no approved monotherapies targeting Ang-2.

Michael Colucciello, MD

Specialties: Ophthalmology

Bio: Michael Colucciello, MD, is an author in Retinal Physician whose work in the provided source article focuses on retinal disease, including macular atrophy associated with anti-VEGF therapy for wet age-related macular degeneration.

Arshad M. Khanani

Affiliations: Sierra Eye Associates

Bio: Arshad M. Khanani, MD, MA, FASRS, is affiliated with Sierra Eye Associates and focuses on retinal disease, including diabetic macular edema. At the ARVO 2026 meeting, he presented phase 2 Alluvium study data evaluating the IL-6 inhibitor vamikibart in treatment-naïve patients with center-involving diabetic macular edema, including comparisons with anti-VEGF therapy.

Contributions:

https://www.retinalphysician.com/issues/2026/may-june/arvo22

Jennifer I. Lim

Specialties: Ophthalmology

Bio: Jennifer I. Lim, MD, FARVO, FASRS, writes on retina care and retinal disease management. In Retinal Physician, she has addressed anti-VEGF therapy, Ang-2 suppression, faricimab, and clinical questions surrounding efficacy and durability in the treatment of pathologic retinal and choroidal vascularization.