# Geographic Atrophy Progression in Clinical Practice Before and After Pegcetacoplan Treatment

## TL;DR

This study shows that pegcetacoplan treatment reduces retinal damage progression in patients with geographic atrophy due to age-related macular degeneration.

## Contribution

The study provides real-world evidence of pegcetacoplan's effect on retinal depletion rates in geographic atrophy.

## Key findings

- Pegcetacoplan reduced RPE and EZ depletion rates from 0.25 mm/year to 0.096 mm/year and 0.26 mm/year to 0.049 mm/year.
- Most patients had subfoveal GA and concurrent neovascular AMD at treatment initiation.
- BRVA loss rates remained unchanged before and after treatment.

## Abstract

This retrospective study evaluated changes in ocular characteristics and retinal pigment epithelium (RPE) and photoreceptor ellipsoid zone (EZ) depletion rates before and after intravitreal pegcetacoplan initiation in clinical practice. A total of 168 eyes from 110 patients with GA secondary to age-related macular degeneration (AMD) who received at least 3 pegcetacoplan injections were included. Data was collected from 5 years before to 9 months after pegcetacoplan initiation. RPE and EZ depletion areas were measured using an automated artificial intelligence (AI) algorithm on optical coherence tomography (OCT) images. At baseline, 76 eyes (45.2%) had concurrent neovascular AMD (nAMD), with mean RPE and EZ depletion areas of 3.3 mm2 and 4.9 mm2, respectively. By pegcetacoplan initiation, these increased to 8.6 mm2 and 11.2 mm2, respectively, with 151 eyes (89.9%) having concurrent nAMD and 155 eyes (92.3%) having subfoveal GA. Pre-treatment to post-treatment RPE and EZ square root depletion rates decreased from 0.25 mm/year to 0.096 mm/year, and 0.26 mm/year to 0.049 mm/year, respectively. Mean best-recorded visual acuity (BRVA) worsened by 0.05 logMAR annually before and after treatment. These real-world findings align with data from the pegcetacoplan phase 3 trials, showing reduced RPE and EZ depletion rates without changes in rates of BRVA loss. Additional studies are warranted.