Future of Wet AMD Treatment


Diana Do, MD, and Steven Peskin, MD, MBA, FACP, discuss unmet needs and future approaches to treatment in wet AMD.

Diana Do, MD: Currently, there’s still an unmet need in the treatment of wet age-related macular degeneration [AMD]. Although treat-and-extend regimens or even fixed-dosing regimens have shown to be very efficacious and safe for the treatment of this disease, we understand that in clinical practice, there are many challenges for patients to adhere to any of these regimens. When we looked at retrospective studies to evaluate the number of treatments a patient might have, on average, over a 1-year period, we’ve seen that many patients in clinical practice are undertreated and maybe receive only 5 to 6 injections over a 1-year period. Why is this so? It’s difficult for an older patient to come frequently to the retina specialist’s office, because they often rely on caregivers or family members to bring them to the retina specialist’s office. Therefore, there’s still a significant unmet need to develop novel therapies that can be administered in the clinic, that can provide a more durable clinical effect of VEGF suppression. That’s why we’re excited to see more medicine and biologics in development in phase 3 clinical trials at this time, which are looking to address this unmet need.

Steven Peskin, MD, MBA, FACP: As with virtually any medical condition, you can always aspire to a better treatment [of wet AMD] when that doesn’t reduce the decline of the person for. [Like for treating] Parkinson disease—I was just talking on the phone with someone about that earlier today—vs curing the disease. Of course, there’s an opportunity in wet AMD, whether it’s a gene therapy or something very meaningful, in the sense that it stops the disease in its tracks vs reducing the rate of decline, so there’s always that aspirational unmet need. With regard to the treatments available, they’re good, they’re well tolerated, and they have some very good efficacy or effectiveness as it relates to reducing the loss of visual acuity in wet AMD.

Diana Do, MD: In the future, novel intravitreal VEGF inhibitors, which are in phase 3 clinical trials, may provide more treatment choices for retina specialists and their patients. We have very efficacious and safe VEGF inhibitors in clinical practice today, but there still remains an unmet need to develop more durable medicines that can provide more VEGF suppression over a longer period of time. I’m excited to see more medicines in development, such as faricimab, which has completed phase 3 clinical trials, or KSI-301, which is in phase 3 clinical trials. In addition, other agents are being evaluated in late-stage development, which will likely provide retina specialists and their patients with even better clinical options in the near future.

Steven Peskin, MD, MBA, FACP: As with any area where there’s significant economic opportunity, there are new products in development for wet AMD. There are device- and biologic-delivery systems that implant something and then the product is released. There will certainly be those kinds of advances. That’s what life sciences companies do, and they do it very well. There could be some incredible change with gene therapy or something that for family impacts the course of disease. That’s an area of science that I’m less familiar with, but it’s certainly a possibility. From our perspective, we’re going to continue to work with our clinical partners toward better outcomes, affordability, and better levels of patient experience, so that’s the triple aim.

Transcript edited for clarity.

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