Exciting Advancements Coming for Neovascular AMD

The panel discusses the advancements they are most looking forward to in the neovascular AMD space, from new treatments to cutting-edge at-home imaging modalities.

Ehsan Rahimy: Tell me 1 thing you’re excited to find out in this space sometime in the next year. Is there something from a clinical trial that we’re expecting some top line results for? What are you guys most excited about in the neovascular AMD space in the next year?

Caroline Baumal: I’ll go first, because I might run out of ideas if you have to go through all four of us. I’m excited about home OCT. And not just necessarily home OCT, but all sorts of testing. It ties into what Rishi said a bit. Remote diagnostic testing so patients can come in and just receive their treatment. I think that’s going to be a real game changer.

Diana Do: I agree with you. I’m also very excited about high-dose aflibercept, and that data may come out within the next year. That’s looking at extra high molar concentration of aflibercept, and the phase 2 Candela study showed some positive data in relation to both OCT drying effects and visual acuity effects. So that is a promising new therapy and development.

Ali Khan: I’m excited to see if suprachoroidal delivery of gene therapy actually works, because that seems quite simple to do and accessible, not only in the US, but elsewhere. So that would be exciting to me. And then I’m also excited to see how we, as retina specialists, try to advocate and manage all of the financial and regulatory and other concerns with payers, and how we do a good job of getting these options to patients, regardless of what we think is better or worse, because I think that is actually going to be a potentially bigger challenge than anything, looking forward.

Rishi Singh: I’m looking forward to, I think, some of the comparator studies that may come in the future from some of these drugs that are coming into market now. I’m going to really want to see cases and examples and head-to-head studies, which probably will be done by individuals more than they will be done by pharmaceutical companies, to explain the differences in the 2 drugs and what the outcomes can be. I mean, right now everything looks very positive and very rosy, but is it really incrementally better? We’ll learn that, I think, through some of these studies.

Ehsan Rahimy: I think those are all wonderful points. To Rishi’s point, anytime something new comes out, and industry is always picking our minds and saying what we think about this, that, and the other from the clinical trials, the truth will be known over the ensuing 12 to 24 months as retina specialists get comfortable using something and identifying the appropriate patients. And we love collecting series and publishing and presenting data, so we’re going to find out over this next 12-to-24-month period how these drugs actually fare in the clinical world.

And Diana, I was really glad you brought up Candela, too, because the thing I’m most excited about, as I mentioned earlier, is to date nothing’s really shown visual acuity superiority over really anything else in development, so it’s part of a big reason why we’re playing this durability game in trials. But if there’s potentially any signal of something, I thought that was pretty exciting. What we saw from the phase 2 Candela data through 44 weeks, I believe it was, with the high-dose aflibercept arm, which was 8 mg, so 4 times the dosage, had at least had close to 2 plus letters. I think it was like 8 letters of vision gain versus 5.7 letters. So, it’ll be exciting to see what the phase 3 data of that study does show. I think they’re testing it in AMD and DME.

And then a kind of a smaller compound, but I’ve been keeping an eye on it and we’ve gotten periodic updates on it, was from Opthea’s OPT 302. The VEGF CD inhibitor. But at least in phase 2, data, again, seemed to show almost a full line of vision benefit over the ranibizumab arm. So, it’ll be interesting to see, whenever that becomes available there, phase 3 data. I think it was the COAST and ShORe trials that are comparing to aflibercept and ranibizumab if that actually carries through.

So yeah, this was a wonderful discussion on neovascular AMD.