Examining Real-World Attrition Among Patients Undergoing Complement Inhibitor Intravitreal Therapy for Geographic...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacoeconomics

Background:

• Geographic atrophy (GA) and neovascular age-related macular degeneration (nAMD) are leading causes of vision loss.
• Pegcetacoplan and avacincaptad pegol are treatments for GA, but patient retention can be challenging.
• Understanding factors influencing treatment discontinuation is crucial for optimizing patient outcomes.

Purpose of the Study:

• To identify patient characteristics associated with treatment discontinuation for geographic atrophy (GA).
• To analyze predictors of attrition in patients receiving pegcetacoplan or avacincaptad pegol.
• To evaluate the impact of disease characteristics and treatment parameters on patient retention.

Main Methods:

• Retrospective cohort studies utilizing a large, deidentified patient database.
• Analysis of baseline characteristics and follow-up changes over 12 months.
• Application of univariate and multivariate mixed-effects regression models to determine hazard and odds ratios for attrition.

Main Results:

• Treatment retention declined within the first 12 months.
• Baseline predictors of attrition included advanced age (>90 years), pegcetacoplan treatment, presence of nAMD, poor visual acuity (<35 ETDRS letters), and subfoveal GA.
• New nAMD and vision loss (>5 ETDRS letters) were significant predictors of attrition at 12 months.
• Longer treatment intervals for nAMD (>6 weeks) and GA (6-8 weeks) were associated with decreased odds of attrition.

Conclusions:

• Poor baseline vision and the development of new nAMD are significant factors in patient attrition.
• The combination of nAMD and GA, along with treatment burden, presents challenges to patient retention.
• Optimizing treatment intervals may improve patient adherence and long-term management of GA.