Encouraging a Preservation Mindset in GA: Overcoming Hesitation and Embracing Innovation
Panelists discuss how they encourage hesitant colleagues to adopt geographic atrophy therapies by emphasizing the importance of staying current with clinical trial data, starting with highly motivated patients who mirror trial populations, and express excitement about the future of precision medicine through biomarker-guided treatment selection, advanced imaging with artificial intelligence integration, late-stage trials targeting vision as primary end points, and innovative approaches like gene therapy and cell therapy that may eventually restore vision.
For colleagues hesitant to adopt geographic atrophy treatments, the key recommendation is staying informed about available therapies regardless of personal prescribing decisions. All retina specialists should read primary source data from phase 3 clinical trials and review podium presentations to remain current with evolving treatment options. Those who choose not to prescribe these treatments should still discuss their availability with patients and document these conversations for medical-legal purposes. For specialists curious about implementation, the open-label extension studies provide compelling long-term data beyond initial top-line results, demonstrating sustained benefits over extended treatment periods.
Starting with motivated patients who mirror clinical trial populations offers the best introduction to complement inhibitor therapy. Ideal candidates include patients with a family history of vision loss, those who are monocular, or individuals desperately seeking treatment options. These highly motivated patients demonstrate excellent treatment adherence and tolerance, providing realistic clinical experiences for practitioners new to these therapies. Safety remains paramount, and beginning with appropriate patient selection helps ensure positive initial experiences while building clinical confidence with this new therapeutic class.
The future of geographic atrophy treatment holds tremendous promise across multiple domains. Precision medicine approaches aim to identify which patients will respond robustly to complement therapy and determine optimal treatment cadences for individual patients. Advanced imaging biomarkers may predict progression rates and guide treatment selection, whereas artificial intelligence will revolutionize patient identification for clinical trials. Late-stage developments include C1q inhibition trials with vision as primary end points and gene therapy approaches targeting anti-CD59. The most exciting long-term prospect involves cell therapy trials that could potentially restore vision in patients who have already lost sight, representing a paradigm shift from preservation to restoration in geographic atrophy management.
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