The Future of Geographic Atrophy Treatment

Veeral Sheth, MD, MBA: I think with geographic atrophy, we're in the beginning stages of therapeutics. This is like inning number one of the last game of the World Series. We're finally at a point where we have a therapeutic, that does something, right? After years and years of looking for therapeutics, in clinical trials that just didn't pan out. As a clinician who's been involved in a lot of those clinical trials, I'm very excited about the fact that we got something past the finish line, but we know that this is the first step.

While we have something that's efficacious, it requires a heavy treatment burden, right? We can slow the disease down, but I would love to be able to slow the disease down with maybe a more durable agent, something that doesn't need to be given every month or two. That’s, I think, what patients are going to demand over time. We've seen that with our wet AMD and DME patients, and I think this is no different.

I think that in the future of treating geographic atrophy, we're really going to look for kind of three improvements. One is going to be efficacy – we need agents that are going to further slow down the damage being done, and maybe one day even reverse the damage, but that's even further down the road. But, better efficacy. Right now, we're talking 20 to 30% slowing down, maybe we get to 40 or 50%, maybe we get to 70 or 80%. I think it's something that we have to aim towards.

The second thing is durability. How can we achieve these types of endpoints, but with fewer injections, or maybe even alternate routes? Right now, there are people out there looking at gene therapy as an example. This is a perfect place for gene therapy because you can treat potentially one time and get a prolonged treatment effect from that. That’s one of the things that we're looking at, and potentially something that's not as far down the road.

Then, safety. The third thing we look for is safety. We want to make sure that whatever treatments we continue to push forward that they are as safe, if not safer than whatever kind of bar has been set. Right now the bar has been set by SYFOVRE and IZERVAY. We have got to continue to kind of push those three factors and come up with good solutions for patients. We've done it before with neovascular AMD and DME, and I have no doubt we're going to do that for geographic atrophy as well.