Can pegcetacoplan injection (Syfovre) slow down geographic atrophy?
Age-related macular degeneration (AMD) is a chronic, painless disease which affects the macula region of the eye. AMD is a leading cause of vision loss among Australians, particularly those over the age of 50, and is responsible for half of all blindness and severe vision loss. It is estimated that approximately one in seven Australians over the age of 50 will be affected by the disease to some degree, with the prevalence increasing with age.
Geographic atrophy (GA) or dry AMD is one of the subtypes of late-stage AMD, and currently affects roughly 100,000 Australians. Until recently there was no treatment available for this condition, other than supplements and modification of diet. In February of 2023, the Food and Drug Administration in the US has approved the use of pegcetacoplan (Syfovre) for the treatment of GA.
Loss of vision in GA stems from chronic metabolic stress to the retina over many years. There can often be a number of underlying stressors, which may include age, smoking and genetic predisposition. Stress over time results in drusen and lipofuscin being deposited in the retina, causing a number of inflammatory pathways to be activated. This inflammation results in the development of the characteristic lesions in GA.
One of these types of inflammation is known as the complement cascade, which has three separate pathways. Each of these pathways, results in a common end product, C3. With this in mind a number of different medications, including Syfovre, are being investigated as treatment for GA. Two Phase-3 trials in the US (OAKS and DERBY) have demonstrated intravitreal injections of Syvofre at monthly intervals are effective at reducing GA lesion growth. It is important to note that this medication does not reverse or undo any previous damage from GA.
More research (GALE Phase-3) is currently being undertaken into the long-term efficacy and safety of Syfovre intravitreal injections, and results are expected to be available in 2025. Although a TGA application has been lodged, Syfovre is not yet available in Australia. Once available the doctors at QERS will be able to administer Syfovre intravitral injections in rooms, along with our suite of already available anti-VEGF injections. Indeed it is promising to see that more therapeutic options are coming in the pipeline, particularly for debilitating conditions such as GA, which previously had no treatment options.