Real-World Clinical Usage and Safety Profile of Intravitreal Pegcetacoplan in Age-Related Macular Degeneration–Associated Geographic Atrophy

Abstract

Purpose: To examine the clinical usage and safety profile in real-world patients with age-related macular degeneration (AMD) receiving intravitreal pegcetacoplan (Syfovre) for the treatment of geographic atrophy, and to explore the effect of intravitreal pegcetacoplan on neovascular AMD (nAMD) disease activity. Methods: Information on patient demographics, AMD classification, treatment history, visual acuity, and ocular adverse events were extracted from the electronic medical records. Results: A total of 1069 patients (1451 eyes) initiated intravitreal pegcetacoplan treatment between February 2023 and October 2023 and were followed up until March 2024. Patients received a mean (±SD) 3.3 ± 2.1 injections, and the mean (±SD) follow-up after pegcetacoplan administration was 7.5 ± 2.3 months. The majority of this cohort displayed stable visual acuity throughout treatment, with logMAR values in 821 patients remaining within 0.20 of the initial value. Ocular hypertension occurred in 36 patients (2.5% of eyes). Seventy-six patients (5.2% of eyes) with non-neovascular AMD at treatment initiation subsequently developed nAMD. Five patients (0.34% of eyes) had intraocular inflammation, including 3 with anterior uveitis, 1 with nonocclusive retinal vasculitis, and 1 with hemorrhagic occlusive retinal vasculitis with subsequent poor outcomes. A rate of retinal vasculitis of 0.03% per injection and a rate of overall intraocular inflammation of 0.1% per injection were observed. In total, 460 patients with nAMD received intravitreal pegcetacoplan. Stability of the antivascular endothelial growth factor (anti-VEGF) treatment interval was observed in 289 of 396 patients (73%). Preserved or improved visual acuity while undergoing anti-VEGF therapy was noted in 384 of 396 patients (97%). Conclusions: Real-world data on intravitreal pegcetacoplan treatment identifies clinician practice patterns and demonstrates an acceptable safety profile, with complications leading to long-term vision loss following pegcetacoplan administration being rare in this cohort.