According to data presented at the Association for Research in Vision and Ophthalmology Annual Meeting in New Orleans, post-hoc analysis from the GATHER trials, for the first time, signals that reduced rate of vision loss in patients receiving avacincaptad pegol was correlated with reduced geographic atrophy (GA) growth.
Iveric Bio Inc. announced new findings from exploratory analyses of data for avacincaptad pegol (ACP), which were presented today at the 2023 annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), in New Orleans.
According to the company, a post-hoc analysis from the GATHER1 and GATHER2 pivotal Phase 3 clinical trials showed, for the first time in an interventional study in GA, a relationship between GA growth and worsening vision loss. In this combined analysis, greater vision loss was correlated with increased GA growth.
“This is the first time a relationship between disease progression and worsening visual acuity has been observed in GA, connecting anatomy and function,” said Carl Danzig, MD, director, Vitreo-Retinal Services, Rand Eye Institute, Deerfield Beach, Florida, who presented the findings at ARVO. “These data suggest that in the ACP-treated group, the reduction in growth of GA resulted in an overall lower rate of vision loss.”
As previously announced, the post-hoc analysis of GATHER1 and GATHER2 combined data signaled a 56% risk reduction in the rate of persistent vision loss in GA patients receiving ACP 2 mg compared to sham over the first 12 months of treatment. Persistent vision loss was defined as a loss of ≥15 letters in Best Corrected Visual Acuity (BCVA) from baseline measured at any two consecutive visits up to month 12. Multiple sensitivity analyses were conducted to evaluate this finding, including 10- and 20-letter loss at two consecutive visits up to month 12, and results were consistent.
Avacincaptad pegol (ACP) is an investigational drug for treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD) that is currently under evaluation for safety and efficacy by the U.S. FDA. ACP is a novel complement C5 protein inhibitor. Overactivity of the complement system and the C5 protein are suspected to play a critical role in the development and growth of scarring and vision loss associated with GA secondary to AMD. By targeting C5, ACP has the potential to decrease activity of the complement system that causes the degeneration of retinal cells and potentially slow the progression of GA.
ACP met its primary endpoint in the completed GATHER1 clinical trial and the ongoing GATHER2 clinical trial, both of which are randomized, double-masked, sham-controlled, multicenter Phase 3 clinical trials. These clinical trials evaluated the safety and efficacy of monthly 2 mg intravitreal administration of ACP in patients with GA secondary to AMD. For the first 12 months in both trials, patients were randomized to receive either ACP or sham monthly. There were 286 participants enrolled in GATHER1 and 448 participants enrolled in GATHER2. The primary efficacy endpoints in both pivotal trials were based on GA area measured by fundus autofluorescence at three time points: Baseline, Month 6, and Month 12. The mean rate of growth (slope) in GA area from baseline to month 12 using observed data was 35% in GATHER1 and 18% in GATHER2. In GATHER1 and GATHER2 combined, the most frequently reported treatment-emergent adverse events at 12 months in the 2 mg recommended dose were related to the injection procedure. The most common adverse reactions (≥ 5% and greater than sham) reported at 12 months in patients who received ACP 2 mg were conjunctival hemorrhage (13%), increased IOP (9%), and CNV (7%).
Age-related macular degeneration (AMD) is the major cause of moderate and severe loss of central vision in aging adults, affecting both eyes in the majority of patients. The macula is a small area in the central portion of the retina responsible for central vision. As AMD progresses, the loss of retinal cells and the underlying blood vessels in the macula results in marked thinning and/or atrophy of retinal tissue. Geographic atrophy, associated with AMD, leads to further irreversible loss of vision in these patients.