Real-World Outcomes with Complement Inhibitors for Geographic Atrophy: A Comparative Study of Pegacetacoplan versus Avacincaptad Pegol

Ryan B Rush,1– 3 Westin Klein,1 Robert M Reinauer4 1Department of Ophthalmology, Panhandle Eye Group, Amarillo, TX, USA; 2Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA; 3Department of Ophthalmology, Southwest Retina Specialists, Amarillo, TX, USA; 4Department of Ophthalmology, New Vision Eye Center, Vero Beach, FL, USACorrespondence: Ryan B Rush, Department of Ophthalmology, Panhandle Eye Group, 7400 Fleming Blvd, Amarillo, TX, 79106, USA, Tel +1 806 351-1870, Email [email protected]: To compare real-world outcomes in subjects who underwent treatment with intravitreal avacincaptad pegol (IVA) or intravitreal pegacetacoplan (IVP) for geographic atrophy (GA) secondary to age-related macular degeneration (AMD).Methods: This study was undertaken as a retrospective, comparative assessment of subjects who underwent IVA or IVP treatment for GA secondary to AMD at two community-based ophthalmology practices. All subjects included in the study had a visual acuity of ≥ 20/200 at baseline, a total GA lesion area of ≥ 1.5 mm2 and ≤ 17.5 mm2at baseline, and follow-up of 12-months following IVA or IVP initiation. The primary outcome was change in GA lesion size at 12 months. Secondary outcomes were change in logMAR vision at 12 months, total number of complement injections administered over 12 months, and the incidence of exudation at 12 months.Results: A total of 112 subjects were analyzed. There were no significant differences in baseline characteristics between treatment groups. There were no significant differences between IVA and IVP in change in total GA lesion size [1.19 (± 0.33) mm2 versus 1.28 (± 0.37) mm2; p = 0.61], change in visual acuity [− 0.1 (− 0.04 to − 0.16) logMAR versus − 0.09 (− 0.05 to − 0.13) logMAR; p = 0.57], or exudation (p = 0.66) over the 12 month study period, respectively. However, the IVA cohort received more injections compared to the IVP group at 12 months (9.05 (± 1.06) versus 5.96 (± 2.01); p < 0.01).Conclusion: This real-world study reports that treatment with IVA and IVP have similar visual and anatomic outcomes at 12-months, although subjects undergoing treatment with IVP may receive fewer injections to obtain these outcomes. Further studies comparing the safety and efficacy of IVA and IVP are warranted.Keywords: geographic atrophy, avacincaptad pegol, age-related macular degeneration, complement inhibition, izervay, syfovre, pegacetacoplan