Future Treatments for AMD Could Mitigate Burden on Patients

The future of treating age-related macular degeneration (AMD) would primarily focus on more effectively halting the condition rather than slowing it as well as reducing the number and frequency of intravitreal injections needed, according to Paul Hahn, MD, PhD, a retina specialist at NJRetina.

This transcript has been lightly edited for clarity.

Transcript

What are the treatment options for patients living with AMD?

We're very fortunate to have effective treatments for macular degeneration, and I say this because it's not that long ago that we had no treatments for these blinding conditions. So these treatments typically involve medicines that we inject into the eye, what we call intravitreal injections. For wet macular degeneration, these injections that we're putting into the eye typically involve what we call anti-VEGF (vascular endothelial growth factor) antibodies. They're antibodies against VEGF, or now with more, newer therapies, some other angiogenic factors as well. And what they do is they help stop the bleeding and they help stop the vision loss that can occur from wet macular degeneration. These medicines are very important to start promptly, and so it's very important for patients to be vigilant with their vision and seek out care from a retina specialist if they develop those types of symptoms.

For dry macular degeneration, we're also lucky to have new treatment options, which weren't available up until recently. So about 2 years ago, the FDA approved 2 different treatments that helped slow down the growth of atrophy from dry macular degeneration. These are also medicines that we inject into the eye, these intravitreal injections, but work through a different pathway. They modulate the complement pathway, and therefore have been shown to decrease the growth of this atrophy. Importantly, they don't stop or even reverse the disease, but they just help slow down progression, which still continues. But it's great that we now have options to offer patients.

What treatments are in the pipeline that patients can look forward to?

Patients should really be excited that we have a very rich pipeline of therapies. If we think about wet macular degeneration, there are a lot of things that are exciting in that pipeline. One of the biggest unmet needs that retina specialists and patients have identified is the treatment burden. It's difficult for patients to come in every 1 to 3 or now 4 months for regular injections into the eye, often for the rest of their lives. And so there are treatments, such as gene therapy options, which may prove to be a 1 and done treatment option, a so-called cure for some patients. There are other options, like tyrosine kinase inhibitors, which work through a different mechanism of action to help suppress VEGF even further, and also with some formulations prove to be a consistent 6 month therapeutic agent. We're also looking at novel mechanisms of action. There are some patients who don't respond optimally to VEGF therapy alone, and some of these novel mechanisms of action may help those patients as well.

If we think about dry macular degeneration, we're lucky to have first generation treatments in our armamentarium, but there's definitely opportunity to improve. These first generation agents slow down worsening, but they don't stop the disease, or they don't reverse the disease, and we're looking for agents which might be able to do so. Similar to wet macular degeneration therapies, our dry AMD therapies for geographic atrophy are also medicines that need to be injected into the eye every 1 or 2 months, really lifelong. And there are also options such as gene therapy and other mechanisms that are looking to decrease that treatment burden. So there's a very rich pipeline in dry macular degeneration and in wet macular degeneration, and all these will hopefully help patients in the future.