New Macular Degeneration Treatment Syfovre Approved for Geographic Atrophy

Understanding Macular Degeneration

Macular degeneration is an eye disease that causes loss of vision in the macula, which is the central part of the retina at the back of the eye. The macula is responsible for sharp, straight-ahead vision which we rely on for activities like reading, driving, recognizing faces, and seeing details.

Types of Macular Degeneration

There are two main types of macular degeneration:

• Dry macular degeneration - This is the most common type accounting for about 90% of cases. It develops slowly over time as light-sensing cells in the macula break down.
• Wet macular degeneration - This less common type causes vision loss more rapidly. It's caused by abnormal blood vessel growth under the retina which can leak fluid or blood.

Stages of Dry Macular Degeneration

Dry macular degeneration progresses through three stages:

1. Early - Small yellow deposits called "drusen" form under the retina. Often no symptoms.
2. Intermediate - More drusen develops leading to blurry vision. Dark areas or spots may appear in central vision.
3. Advanced "Geographic Atrophy" - Light-sensing cells die leading to permanent blind spots in central vision.

New Treatment Approved for Geographic Atrophy

In October 2022, the FDA approved an injectable medication called Syfovre (pegcetacoplan) to treat geographic atrophy, an advanced form of age-related dry macular degeneration.

What is Geographic Atrophy?

Geographic atrophy is the most advanced stage of dry macular degeneration. It happens when light-sensing cells in the retina die off from lack of blood flow. This causes permanent blind spots to develop which grow and "coalesce" over time.

The blind spots usually start in the center of vision making it difficult to see straight ahead. Over months and years they can grow and fuse together leading to extensive vision loss.

How Syfovre Works

Syfovre works by regulating the immune system to reduce inflammation that contributes to geographic atrophy. It targets a protein called C3 which plays an important role in immune function and has been implicated in dry AMD progression.

In clinical trials, monthly injections of Syfovre into the eye slowed the growth rate of geographic atrophy lesions compared to sham injections. While not a cure, it can potentially buy patients more time with functional vision.

Effectiveness of Syfovre

In phase 3 trials, after 18 months of treatment:

• 27% of Syfovre patients had growth of geographic atrophy lesions of less than 20/40 vision vs. 37% for sham injections
• Syfovre reduced the growth rate of lesions by 27% compared to sham
• No serious side effects occurred. 10% of Syfovre patients had some retinal changes which were not vision threatening.

Who Can Get Syfovre Treatment?

Syfovre is approved for adults with geographic atrophy secondary to dry age-related macular degeneration. It has not been tested in wet macular degeneration or other eye diseases. Patients must have some functional vision remaining for treatment to be worthwhile.

The Future of Macular Degeneration Treatments

The approval of Syfovre represents an important advancement giving doctors the first approved treatment option for those with geographic atrophy dry AMD. However, more progress is still needed.

Early Intervention

Currently Syfovre only treats later stage geographic atrophy when extensive vision loss has already occurred. Future treatments may focus on earlier intervention by addressing drusen or atrophy before it grows too large.

Better Efficacy

While Syfovre was shown to slow lesion growth, vision still declined substantially in many patients over 18 months. Betteragents that stop or reverse geographic atrophy could preserve more functional vision long-term.

Wet Macular Degeneration

Most current AMD treatments target abnormal blood vessels in wet macular degeneration. An unmet need still exists for medications that can stop dry AMD from progressing to geographic atrophy and wet AMD.

Duration of Treatment

It's unknown if Syfovre will need to be given indefinitely. Trials only followed patients for 18 months. Future research may uncover whether short term treatment can yield lasting benefits after discontinuation.

The Takeaway on Macular Degeneration

Age-related macular degeneration is a leading cause of blindness, especially in the elderly. Exciting progress is being made with the first drug approved for geographic atrophy dry AMD. However more research is still needed to find ways of treating macular degeneration earlier and more effectively to preserve vision.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.