Points of View: Geographic Atrophy

Sheppard, MD: There have been remarkable changes, with two new injections to arrest or delay the inevitable blinding progression of geographic atrophy. When patients and referring doctors better understand this quantum change in our ability to treat a previously observed but untreatable disease.

Adyanthaya, MD: Until about a year ago, there was no treatment for geographic atrophy. The lesions slowly progressed in most patients, leading to gradual decline in vision and ultimately legal blindness. However, we now have two FDA-approved treatments, Syfovre (pegcetacoplan injection, Apellis Pharmaceuticals) and Izervay (avacincaptad pegol intravitreal solution, Iveric Bio), which have been shown to statistically slow down the progression of atrophic lesions. This has been a huge milestone in the treatment of this otherwise blinding eye condition. The approval of Syfovre was based on positive results from the phase 3 OAKS and DERBY studies whereas Izervay reached statistical significance in the GATHER trials.

Rachon, OD, FAAO: In 2023, two new treatments came out on the market. These complement inhibitors, Syfovre (pegcetacoplan injection, Apellis Pharmaceuticals) and Izervay (avacincaptad pegol intravitreal solution, Iveric Bio), inhibit the complement pathway that induces inflammation in the retina. These can reduce the progression of geographic atrophy between 20% to 35%, depending on how often the injection is given or which medication is chosen.