Reduction in GA lesion growth may be greater with pegcetacoplan than avacincaptad pegol
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Pegcetacoplan may be a more effective treatment option than avacincaptad pegol for reducing geographic atrophy lesion growth in patients with age-related macular degeneration.
The study, presented at the American Society of Retina Specialists annual meeting by Paul Hahn, MD, PhD, FASRS, a retina specialist at NJRetina, compared intravitreal pegcetacoplan (PEG) vs. avacincaptad pegol (ACP) for the treatment of geographic atrophy (GA). Using anchored matching-adjusted indirect comparisons, researchers evaluated the decrease in GA lesion growth over a 24-month period in patients from phase 3 trials.
“This approach matches and balances the patient population across clinical trials to allow us to compare their findings,” Hahn told Healio in an email interview.
The study compared individual patient data from the phase 3 OAKS and DERBY trials of pegcetacoplan and aggregate data from the GATHER2 trial of avacincaptad pegol. It balanced key baseline variables through propensity score weighting and compared the change in GA lesion area from baseline to 12 months and 24 months.
The pegcetacoplan group demonstrated a significantly greater reduction in GA lesion growth compared with the avacincaptad pegol group, according to the study results.
“By comparing the phase 3 trials of PEG vs. ACP, we were able to identify greater efficacy with PEG vs. ACP in reducing growth of extrafoveal GA lesion size,” Hahn said. “A statistically significant difference favoring PEG was found with monthly and every other month dosing compared to ACP monthly, with an approximately 25% to 30% greater reduction in GA growth with PEG.”
Hahn acknowledged the study’s limitations, noting that prospective head-to-head trials are the gold standard for comparison.
“This type of analysis is limited by factors like its retrospective design, the availability of patient-level data only for the PEG patients ... and a reduction in sample size as a result of the matching/balancing process,” he said.
“As we continue to learn more about these complement inhibitors, comparative analyses beyond just clinical trial efficacy will continue to be of value,” Hahn said. “Important but unanswered questions include who benefits most from these treatments, how to follow these patients and how do we measure success in the clinic setting.”
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Hahn P, et al. Pegcetacoplan vs avacincaptad pegol in geographic atrophy: Anchored matching-adjusted indirect comparisons of three Phase 3 trials over 24 months. Presented at: American Society of Retina Specialists annual meeting; July 17-20, 2024; Stockholm.
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