Advancements in AMD Management: 5-Year Insights on Pegcetacoplan and Geographic Atrophy

Pegcetacoplan (Syfovre)given continuously for five years slows geographic atrophy (GA) progression versus a projected sham in a post hoc GALE long-term extension analysis.

The benefit was seen in participants who continued monthly or every-other-month dosing and translated into a sustained structural advantage that delays the expected trajectory toward foveal involvement—an outcome that matters because it can postpone central vision loss and influence decisions about earlier, ongoing treatment.

The report describes lesion-area growth as the endpoint and compares annualized GA growth for nearly 800 participants who continued treatment with a projected sham constructed from original trial linear-growth estimates and cross-validated with fellow-eye data.

Slower lesion growth is concordant with potential preservation of central vision, although long-term visual-acuity preservation data remain limited and should be interpreted cautiously. Treatment requires intravitreal injection on monthly or every-other-month schedules, creating a sustained treatment burden that must be discussed with patients. Those with noncentral GA at high risk for foveal involvement and patients willing to adhere to regular injections are most likely to gain functional benefit and should be counseled accordingly.

Five-year safety outcomes were consistent with prior reports and did not reveal new ocular or systemic adverse events, supporting a stable long-term safety profile. Expected injection-related risks—such as intraocular inflammation and endophthalmitis—remain considerations. Routine postinjection monitoring for inflammatory signs, visual changes, and injection-site complications is advised to maintain vigilance while treating appropriate patients.

Key Takeaways:

• Continuous Pegcetacoplan for five years showed a sustained relative reduction in GA lesion growth versus a projected sham, indicating a durable structural benefit for noncentral GA patients.
• Patients with noncentral GA at risk for foveal involvement, and those willing to accept monthly or every‑other‑month intravitreal injections, are most likely to benefit—informing selection and counseling.
• Integrate these long-term efficacy and safety data into counseling and monitoring pathways; consider registry enrollment and continued follow-up to refine patient selection and treatment cadence.