Pegcetacoplan Does Not Impact Anti-VEGF Treatment in Geographic Atrophy, With Ted Leng, MD, MS

According to a recent real-world evaluation, adding pegcetacoplan on top of anti-VEGF treatment for geographic atrophy (GA) does not interrupt anti-VEGF treatment patterns.¹

Pegcetacoplan’s efficacy in GA treatment has been well documented through the phase 3 OAKS, DERBY, and GALE studies. The drug reduced the mean rate of change in GA area substantially across all 3 trials compared to projected sham – these improvements increased after multiple years of follow-up.²

“Historically, we haven’t had much real-world data on how these dual therapies interact outside of clinical trials,” Ted Leng, MD, MS, professor of ophthalmology and director of clinical and translational research at Stanford University School of Medicine, told Modern Retina in an exclusive interview. “In our 18-month analysis, we found that about 1/3 of eyes being treated with pegcetacoplan already had a history of anti-VEGF treatment. And the most encouraging finding for retina specialists is the striking stability of both the treatment patterns and the clinical outcomes.”

Leng and colleagues utilized the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) Registry. Patients with GA who had received their first pegcetacoplan injection between March 2023 and December 2024 were included, so long as they had ≥12 months of pre-index data, 6 months of potential follow-up, and a visual acuity (VA) measurement at baseline.¹

The team then divided included eyes into cohorts based on whether they had received anti-VEGF injections pre- and/or post-index. Treatment patterns with pegcetacoplan and anti-VEGF were also evaluated.¹

A total of 49,313 eyes from 34,908 patients were ultimately included. Of these, 31% of eyes (n = 15,510) had received anti-VEGF prior to pegcetacoplan, 7% (n = 3527) had only received anti-VEGF on or after index, and 61% (n = 30,276) did not receive anti-VEGF pre- or post-index. Across all 3 cohorts, the patient population had a median age of 82-84 years and was 77% white and 67% female.¹

Additionally, 53% of patients received pegcetacoplan bilaterally during the study. All eyes were given a median of 5 pegcetacoplan injections per year, with an average interval between injections of around 56 days for eyes across all cohorts. The "anti-VEGF first” and “pegcetacoplan first” cohorts were given a median of 5 and 3 anti-VEGF injections per year post-index, respectively. 75% of patients in the “anti-VEGF first” cohort (n = 11,590) also received anti-VEGF injections post-index. The median of the mean anti-VEGF intervals was 59 days, and the median change in anti-VEGF intervals between pre- and post-index was +8 days.¹

Ultimately, the majority of eyes previously treated with anti-VEGF (75%) were also on anti-VEGF post-index while receiving concomitant pegcetacoplan. Prior or current anti-VEGF treatment did not impact pegcetacoplan treatment patterns. Leng and colleagues plan additional follow-up analyses to examine VA outcomes.¹

“And lastly, most importantly, the visual acuity remained broadly stable across the board during the 18-month follow-up window,” Leng said. “And this is for all 3 different patient groups that we looked at, and it shows us that adding the complement inhibitor doesn’t really throw off the cadence of anti-VEGF therapy – patients are able to safely maintain their vision while we manage both of these conditions at the same time.”

Editor’s Note: Leng reports disclosures with Astellas, Boehringer Ingelheim, Roche/Genentech, Luxa Biotechnology, Topcon, Toku, and others.

References

1. Leng T, Schneider E, Rahimy E, et al. Real-world Pegcetacoplan and Anti-VEGF Treatment Patterns among Patients with Geographic Atrophy. Abstract presented at the 49th Annual Macula Society Meeting. San Diego, CA. February 25-28, 2026.

2. Wykoff CC, Holz FG, Chiang A, et al. Pegcetacoplan Treatment for Geographic Atrophy in Age-Related Macular Degeneration Over 36 Months: Data From OAKS, DERBY, and GALE. Am J Ophthalmol. 2025;276:350-364. doi:10.1016/j.ajo.2025.04.016