Pegcetacoplan Demonstrates Vision Benefits in Geographic Atrophy Across AMD Variants

MONTREAL — Geographic atrophy (GA) showed comparable responses to the complement inhibitor pegcetacoplan (Syfovre) in patients with or without concurrent neovascular age-related macular degeneration (nAMD), according to data presented at the American Society of Retina Specialists (ASRS) meeting.

Compared to pre-treatment status, GA progression—measured by retinal pigment epithelium (RPE) loss—slowed by 23% in eyes with GA alone and 40% in eyes with concurrent nAMD. Photoreceptor (PR) loss also decreased in both groups, with a larger reduction observed in the combined-disease cohort (-58% vs. -41%). Faster-progressing eyes prior to treatment remained so but at a reduced rate after pegcetacoplan initiation, as reported by Hasenin Al-khersan, MD, of the Retina Group of Florida.

“We observed similar atrophy progression rates pre-pegcetacoplan in eyes with GA alone and those with GA plus neovascular AMD,” Al-khersan stated. “Post-treatment, pegcetacoplan significantly reduced RPE and photoreceptor atrophy over 12 months in both groups, with more pronounced effects in the combined-disease cohort.”

Complementary findings from a second ASRS presentation, a propensity-matched analysis, indicated slower visual acuity decline in pegcetacoplan-treated eyes, either alone or alongside anti-VEGF therapy for nAMD. “The visual benefit was most significant in patients receiving both pegcetacoplan and anti-VEGF compared to anti-VEGF alone,” explained Nimesh Patel, MD, of Mass Eye and Ear in Boston. “Statistically significant improvements persisted at all time points, with fewer patients losing ≥15 letters in the pegcetacoplan groups.”

The results build on prior real-world data showing 25% of GA patients also received concurrent nAMD treatment. Patel noted, “This highlights the need for integrated management strategies as both conditions often coexist. While further studies are required, pegcetacoplan appears a viable and safe option.”

Al-khersan’s group evaluated optical coherence tomography changes in 240 GA-only and 257 GA/nAMD eyes, using AI-assisted RetinAI Discovery. Over 24 months (pretreatment and post-treatment), baseline lesion sizes and annualized RPE/PR loss rates were similar between groups. Post-pegcetacoplan, both cohorts showed significant reductions in atrophy progression (P<0.001), with greater effects in the combined-disease group (RPE: 0.96 vs. 1.17 mm²/yr; PR: 0.70 vs. 0.97 mm²/yr).

Patel’s team analyzed 511 pegcetacoplan-alone, 564 untreated, 328 combination, and 394 anti-VEGF-only patients over 18 months. Pegcetacoplan alone significantly preserved visual acuity (57.9 → 52.1 vs. control’s 59.9 → 47.0 letters) and reduced ≥15-letter loss (10.2% vs. 26.6% at 12 months, P=0.003). Combined therapy further outperformed anti-VEGF monotherapy at all time points, with the most pronounced effect at 18 months (16.0% vs. 33.8% letter loss, P=0.021).

“This is the first study—clinical or real-world—to demonstrate a statistically significant visual benefit from pegcetacoplan in GA, both alone and with anti-VEGF,” Patel concluded.

Source link