ASRS 2025: 48-month results from OAKS, DERBY, and GALE open-label extension

Roger A. Goldberg, MD, MBA, from Bay Area Retina Associates presented 48-month data on pegcetacoplan for geographic atrophy (GA) treatment at the ASRS 2025 conference in Long Beach, California.

The research stems from the DERBY and OAKS clinical trials, which transitioned into an open-label extension study called GALE. The study's key findings reveal significant advances in preserving retinal tissue through continuous treatment. In the non-subfoveal population, monthly treatment preserved 3.16 square millimeters of retinal tissue over 4 years, while every-other-month treatment preserved 2.77 square millimeters. Notably, the treatment's effectiveness increased over time, with greater tissue preservation and slower GA growth in years 3 and 4 compared to the initial 2 years.

Patients who delayed treatment saw markedly less benefit. Those who waited 2 years before starting treatment only preserved 1.1 square millimeters of retinal tissue, compared to those receiving continuous treatment. The microperimetry data demonstrated a compelling 35% risk reduction in early-treated patients, particularly in the critical central 4 and 16 loci of vision.

The safety profile remained consistent with previous studies, supported by an impressive real-world dataset of over 700,000 pegcetacoplan injections, including more than 100,000 new treatment starts. This extensive real-world experience provides a robust safety compendium and validates the long-term treatment approach.

The research underscores the importance of early and continuous intervention in managing geographic atrophy. By preserving retinal tissue and reducing the risk of absolute scotoma progression, pegcetacoplan offers a promising therapeutic strategy for patients with this degenerative condition. Goldberg's presentation highlights the potential of targeted, long-term treatment in slowing geographic atrophy's progression, offering hope for patients by maintaining critical visual real estate and potentially improving long-term visual outcomes.