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Brimonidine seen as promising treatment for geographic atrophy

Issue: October 2016

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CHICAGO — Neuroprotective brimonidine as a treatment for geographic atrophy is promising, William R. Freeman, MD, told colleagues at Retina Subspecialty Day preceding the American Academy of Ophthalmology meeting.

Freeman reported results of a phase 2 randomized clinical trial of brimonidine administered intravitreally using a 22-gauge insert placed in the eye that released brimonidine over a period of 6 months. Allergan sponsored the trial.

William R. Freeman

Doses of 132 µg and 264 µg brimonidine were given at baseline and at 6 months in 49 and 41 patients, respectively, and compared with sham treatment in 23 patients to evaluate safety and efficacy of the repeat injection on retinal structure and visual function in patients with geographic atrophy secondary to age-related macular degeneration.

The primary endpoint at 12 months was change in lesion size from baseline.

“Although this study was not powered to show statistically significant difference in efficacy, we are seeing differences in efficacy,” Freeman said.

At 12 months, 18.8% and 27.5% reductions in geographic atrophy progression rates were observed in the low and high dose groups, respectively.

“We’re aware of what a terrible disease this is. It is inexorably progressive. And we do not have a good, or even a reasonably good treatment for this disease,” Freeman said. He further reported that a second study, the Beacon study, is fully enrolled with 300 patients and will evaluate a “more potent delivery method” of brimonidine via a 25-gauge intravitreal implant. – by Patricia Nale, ELS

Reference:

Freeman WR. Intravitreal brimonidine drug delivery system (brimonidine DDS) in patients with geographic atrophy: A phase 2 study. Presented at: American Academy of Ophthalmology annual meeting; Oct. 14-18, 2016; Chicago.

Disclosure: Freeman reports he is a consultant for Allergan, Alcon, Spinnaker and Nanovision.