Controversies in Modern Eye Care 2023: Advances in geographic atrophy

David S. Boyer, MD, senior partner at Retina Vitreous Associates Medical Group, shares key takeaways from his featured symposium, "Advances in geographic atrophy," which he co-presented during the 17th annual Controversies in Modern Eye Care symposium at the Skirball Cultural Center in Los Angeles, California.

This transcript has been edited for clarity.

David S. Boyer, MD:

Good morning made name is David Boyer, I am senior partner at Retina Vitreous Associates Medical Group and an adjunct clinical professor at USC Medical School. It was my pleasure today to present the geographic atrophy lecture.

Geographic atrophy, as you know, has not been something that we've been able to treat. But recently, one drug, a C3 inhibitor, pegcetacoplan, was approved by the FDA to treat patients with geographic atrophy.

The results are encouraging, there was an improvement in approximately 17 to 19% of patients in reducing the growth of the lesion. However, you know, we were concerned about the vision.

While recently there was a small article that came out from the ARVO meeting, which I just recently attended, that indicated that there was actually a 5 letter difference in the favor of the treatment group in patients who had lesions that were extra foveal or greater than 20, or 50 microns from the fovea. So this means that we should identify these patients early because we can maintain their vision longer.

Right behind this approval, there's another drug, a C5 inhibitor from Iveric Bio, that also is treating extra fovea lesions, has a very similar side effect profile, and a very similar mode of action. As you're aware there are probably 7 other companies in this space all trying to downregulate the alternative pathway. The reason for that is it seems to be that a upregulation of the alternative pathway appears to be the commonality for these to occur.

We know that complements found in the pigment epithelium, and drusen and other areas, and this activation of the complement system seems to cause eventual apoptosis and loss of cells.

So there are a number of companies that are still in phase 2, hopefully will, come forward and improve the progression—or reduce the progression—of these lesions. It's important to realize that these are intravitreal injections that are being given, and unfortunately, they're be giving fairly frequently. The approval was four to eight weeks, and for Apellis this was the first drug that's been approved in the space.

I thank you for your attention today.