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Treating Geographic Atrophy Remains a Tough Call for Ophthalmologists as They Voice Hesitancy to Prescribe Complement Inhibitors

Ophthalmologists are cautious about prescribing the current geographic atrophy (GA) treatment options Syfovre and Izervay, introduced in 2023 as the first-ever therapy for GA, according to Spherix Global Insights.

EXTON, PA., June 27, 2024 – Prior to 2023, there was no treatment for GA, a progressive form of dry age-related macular degeneration that results in blindness. That changed in early 2023 when Apellis gained FDA approval for Syfovre, followed by Iveric Bio/Astellas’ approval for Izervay later in the year. Both treatments are classified as complement inhibitors, administered via monthly/every other month intravitreal injections, and aim to prevent further vision loss. However, neither fully prevents nor reverses the progression of GA, making it difficult for some physicians and patients to see the value in these new treatment options.

Shortly after Syfovre’s launch, the American Society of Retina Specialists (ASRS) issued a warning about potential vascular adverse events, which led to a cautious approach among eye care professionals. This caution, reflected in Spherix Global Insights report series, contributed to some ophthalmologists’ reluctance to prescribe either Syfovre or Izervay and created a desire for alternative interventions. Although physician hesitancy regarding safety concerns has begun to recede, other barriers such as efficacy remain.

A broader perspective from Spherix’s 2024 Market Dynamix™: Geographic Atrophy (US) study reveals that only 21% of GA patients receive intravitreal therapy despite the condition’s progression to blindness. One retinal specialist noted:

“I’m not very satisfied. I think [complement inhibitors] have significant risks and their efficacy is pretty limited.”

Ophthalmologists report that they typically watch and wait for the GA to encroach upon the fovea – or central part of the retina – before initiating treatment. The study found that ophthalmologists want new GA treatments that can hopefully reduce lesion growth by about 50%, as opposed to Syfovre’s effect which slows lesion growth less than 25%. As one retinal specialist emphasized:

“I think the biggest thing would be just better efficacy with a greater level of safety because if there is something that will slow it down, but there’s a really high risk of the patient losing vision, then none of us are going to use it.”

Through Spherix’s continued monitoring of the GA treatment market in Launch Dynamix™: Syfovre and Izervay in GA (US),several important trends have emerged in 2024. Presentations at The Association for Research in Vision and Ophthalmology (ARVO) 2024 conference indicate that retinal specialists are now prioritizing GA treatment over concerns about side effects. Over 60% of ophthalmologists believe the disease’s risks outweigh treatment side effect risks, though about a third remain uncomfortable prescribing Syfovre. In practice, ophthalmologists often reserve Syfovre for more severe GA cases and use Izervay for less advanced patients or those concerned with Syfovre’s safety, as many ophthalmologists view Izervay as having a better safety profile.

Spherix Global Insights also explored pipeline GA therapies from the likes of Alexion, Alkeus, Annexon, Belite Bio, Johnson & Johnson, and Ionis/Genentech in the 2024 Market Dynamix™ study and will continue to monitor these GA trends and provide valuable insights to improve patient outcomes in the future.

Market Dynamix™ is an independent service providing strategic guidance through annual reports, which include market trending and physician’s assessments of unmet need and investigational assets’ projected ability to meet those needs. The reports provide an unbiased view of the competitive landscape within rapidly evolving specialty markets, fueled by robust HCP primary research and our in-house team of experts.

Launch Dynamix™ is an independent service providing monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into promotional activity, barriers to uptake, and patient types gravitating to the launch brand.

About Spherix Global Insights 

Spherix is a leading independent market intelligence and advisory firm that delivers commercial value to the global life sciences industry, across the brand lifecycle.

The seasoned team of Spherix experts provides an unbiased and holistic view of the landscape within rapidly evolving specialty markets, including dermatology, gastroenterology, rheumatology, nephrology, neurology, ophthalmology and hematology. Spherix clients stay ahead of the curve with the perspective of the extensive Spherix Physician Community.

As a trusted advisor and industry thought leader, Spherix’s unparalleled market insights and advisory services empower clients to make better decisions and unlock opportunities for growth.

To learn more about Spherix Global Insights, visit or connect through LinkedIn

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Spherix Global Insights Contact

Blaine Cloud, Ophthalmology Franchise Head,

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