Real-world Safety Profile of Avacincaptad Pegol in the Management of Geographic Atrophy

This study evaluated the safety of intravitreal avacincaptad pegol in treating geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

A retrospective review was conducted of patients treated with avacincaptad pegol at Bascom Palmer Eye Institute from January 2024 to January 2025. Adverse events, side effects, and potential risk factors were recorded.

The study analyzed 124 eyes from 83 patients (mean age 81.8 ± 6.4 years; 49.4% male; 91.6% White) who received 409 injections in total. Injection intervals varied: 54 eyes monthly, 55 every other month, and others less frequently. The variability in injection frequency was mostly due to patient difficulty with follow-up. Follow-up ranged 3 to 12 months (median: 5 months). Baseline visual acuity averaged 0.40 (approx. 20/50 Snellen) decreasing slightly to 0.38 (20/53 Snellen)-not statistically significant (P = .628). Most eyes (85.2%) were pseudophakic; 47% of patients had prior neovascular AMD treated with anti-vascular endothelial growth factor (anti-VEGF), and 24.2% were simultaneously being treated for active neovascular AMD in the eye receiving avacincaptad pegol. Sixteen eyes had prior pegcetacoplan treatment. Adverse events were rare. One patient developed culture-negative endophthalmitis 4 days after the third injection, presenting with vision loss to hand motion but improving after intravitreal antibiotics. Side effects occurred in 14 eyes (13.8%) across 10 patients, including intraocular pressure elevation (seven eyes), discomfort (four eyes), visual disturbance (two eyes), and subconjunctival hemorrhage (one eye). Five patients discontinued treatment, and one eye (0.8%) had reactivation of neovascular AMD.

Our study highlights the safety profile of avacincaptad pegol for GA, with a low incidence of conversion to neovascular AMD, few adverse events, and manageable side effects.