Treating Geographic Atrophy Remains a Tough Call for Ophthalmologists as They Voice Hesitancy to Prescribe Complement Inhibitors
27 June 2024 - 1:49PM
Prior to 2023, there was no treatment for GA, a progressive form of
dry age-related macular degeneration that results in blindness.
That changed in early 2023 when Apellis gained FDA approval for
Syfovre, followed by Iveric Bio/Astellas’ approval for Izervay
later in the year. Both treatments are classified as complement
inhibitors, administered via monthly/every other month intravitreal
injections, and aim to prevent further vision loss. However,
neither fully prevents nor reverses the progression of GA, making
it difficult for some physicians and patients to see the value in
these new treatment options.
Shortly after Syfovre's launch, the American Society of Retina
Specialists (ASRS) issued a warning about potential vascular
adverse events, which led to a cautious approach among eye care
professionals. This caution, reflected in Spherix Global Insights
report series, contributed to some ophthalmologists' reluctance to
prescribe either Syfovre or Izervay and created a desire for
alternative interventions. Although physician hesitancy regarding
safety concerns has begun to recede, other barriers such as
efficacy remain.
A broader perspective from Spherix's 2024 Market Dynamix™:
Geographic Atrophy (US) study reveals that only 21% of
GA patients receive intravitreal therapy despite the condition's
progression to blindness. One retinal specialist noted:
“I’m not very satisfied. I think [complement inhibitors] have
significant risks and their efficacy is pretty limited.”
Ophthalmologists report that they typically watch and wait for
the GA to encroach upon the fovea – or central part of the retina –
before initiating treatment. The study found that ophthalmologists
want new GA treatments that can hopefully reduce lesion growth by
about 50%, as opposed to Syfovre's effect which slows lesion growth
less than 25%. As one retinal specialist emphasized:
“I think the biggest thing would be just better efficacy with a
greater level of safety because if there is something that will
slow it down, but there's a really high risk of the patient losing
vision, then none of us are going to use it.”
Through Spherix’s continued monitoring of the GA treatment
market in Launch Dynamix™: Syfovre and Izervay in GA (US),
several important trends have emerged in 2024. Presentations at The
Association for Research in Vision and Ophthalmology (ARVO) 2024
conference indicate that retinal specialists are now prioritizing
GA treatment over concerns about side effects. Over 60% of
ophthalmologists believe the disease's risks outweigh treatment
side effect risks, though about a third remain uncomfortable
prescribing Syfovre. In practice, ophthalmologists often reserve
Syfovre for more severe GA cases and use Izervay for less advanced
patients or those concerned with Syfovre's safety, as many
ophthalmologists view Izervay as having a better safety
profile.
Spherix Global Insights also explored pipeline GA therapies from
the likes of Alexion, Alkeus, Annexon, Belite Bio, Johnson &
Johnson, and Ionis/Genentech in the 2024 Market Dynamix™
study and will continue to monitor these GA trends and provide
valuable insights to improve patient outcomes in the future.
Market Dynamix™ is an independent service providing
strategic guidance through annual reports, which include market
trending and physician’s assessments of unmet need and
investigational assets’ projected ability to meet those needs. The
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primary research and our in-house team of experts.
Launch Dynamix™ is an independent service providing
monthly benchmarking of newly launched products for the first
eighteen months of commercial availability, augmented by a
quarterly deep dive into promotional activity, barriers to uptake,
and patient types gravitating to the launch brand.
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Blaine Cloud, Ophthalmology Franchise Head
Spherix Global Insights
4848794284
Blaine.cloud@spherixglobalinsights.com