Geographic Atrophy Progression in Clinical Practice Before and After Pegcetacoplan Treatment

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Technology

Background:

• Geographic atrophy (GA) secondary to age-related macular degeneration (AMD) leads to progressive vision loss.
• Current treatment options for GA are limited, highlighting the need for effective therapies.
• Pegcetacoplan is an intravitreal drug targeting complement C3, showing promise in slowing GA progression.

Purpose of the Study:

• To evaluate the real-world effectiveness of intravitreal pegcetacoplan in reducing RPE and EZ depletion rates in GA patients.
• To assess changes in ocular characteristics and visual acuity before and after pegcetacoplan initiation in a clinical setting.
• To compare real-world findings with data from previous pegcetacoplan clinical trials.

Main Methods:

• Retrospective study of 168 eyes from 110 patients with GA secondary to AMD.
• Data collected from 5 years pre-treatment to 9 months post-treatment with intravitreal pegcetacoplan.
• Automated artificial intelligence (AI) algorithm used on optical coherence tomography (OCT) images to measure RPE and EZ depletion areas.
• Analysis of RPE and EZ depletion rates and best-recorded visual acuity (BRVA) changes.

Main Results:

• Significant reduction in RPE and EZ square root depletion rates post-pegcetacoplan initiation (0.25 mm/year to 0.096 mm/year for RPE; 0.26 mm/year to 0.049 mm/year for EZ).
• Despite reduced depletion rates, mean BRVA worsened by 0.05 logMAR annually, both pre- and post-treatment.
• High prevalence of concurrent neovascular AMD (nAMD) and subfoveal GA observed at baseline and initiation.

Conclusions:

• Intravitreal pegcetacoplan effectively reduced RPE and EZ depletion rates in GA patients in a real-world clinical setting.
• The drug did not alter the rate of visual acuity loss, consistent with phase 3 trial findings.
• Further research is warranted to fully understand the long-term impact of pegcetacoplan on GA progression and visual function.