Early Versus Delayed Pegcetacoplan Treatment for Geographic Atrophy Secondary to Age-Related Macular Degeneration in OAKS, DERBY, and GALE.

In 30 seconds

This analysis compared early with delayed pegcetacoplan treatment for geographic atrophy secondary to age-related macular degeneration, using data from the phase 3 OAKS and DERBY trials and their open-label extension, GALE. Eyes treated continuously for 48 months were compared with eyes initially observed with sham and treated after 24 months. In the overall population, continuous treatment reduced geographic atrophy growth rate by up to 24% versus projected sham, corresponding to 1.88 mm² of retinal tissue preserved. Early treatment preserved more retinal tissue in eyes with nonsubfoveal disease; safety findings were consistent with the earlier trials.

Key findings

• Continuous pegcetacoplan for 48 months reduced geographic atrophy growth rate by up to 24% versus projected sham, preserving 1.88 mm² of retinal tissue.
• For nonsubfoveal disease, early monthly treatment preserved up to 3.16 mm² of retinal tissue versus 1.11 mm² with delayed treatment.
• In the overall population, risk of progression to absolute scotoma was reduced by 32% across central 4 loci and 43% across central 16 loci.
• GALE safety findings were consistent with those reported in OAKS and DERBY.

Why it matters

Geographic atrophy can compromise retinal tissue and visual function. These findings suggest that sustained complement inhibition may slow anatomical progression and that starting treatment earlier may preserve more retinal tissue, particularly in nonsubfoveal disease. The reported reduction in progression to absolute scotoma also provides a functional outcome relevant to the potential value of treatment over time.

What to keep in mind

The early-versus-delayed comparison used data from an open-label extension; delayed-treatment eyes crossed over from sham, and the 48-month reduction was compared with projected sham.