New treatments in the pipeline

Wet AMD

New longer acting drugs:

• Beovu (brolucizumab) – Scottish Medicines Consortium and NICE have approved it for use for wet AMD patients. It is available in eye clinics now as a treatment option. People may only need an injection every 8-12 weeks.
• Vabysmo (faricimab) – new type of drug with dual action to address two different aspects of wet AMD. People may only need an injection every 3-4 months. It has been approved in England and Wales for use on the NHS.
• Susvimo (previously called the Port Delivery System) – a reservoir of Lucentis in the eye, which releases the drug gradually and can be re-filled every 6 months. It has been approved for use in the USA and is being considered by authorities in the UK but has had some technical problems so approval is delayed.
• High dose Eylea – a higher dose version of Eylea (8 mg) has just been approved. It will enable up to 16 weeks between injections.

Dry AMD

Researchers are looking at different ways to find a treatment as AMD is a complex disease, still not fully understood. A popular approach is to look for drugs which will reduce inflammation in the eye cells, which causes damage and leads to sight loss. Another approach is to try and keep the photoreceptors alive for longer. Both approaches would slow the progress of the disease.

The first drug to treat geographic atrophy (GA) or late stage dry AMD has been approved for use in the USA. Pegcetacoplan, produced by drugs company Apellis, will be marketed under the name Syfovre.  It will be administered through eye injections either monthly or every other month. In Europe the European Medicines Agency and in the UK the Medicines and Healthcare Products Regulatory Agency are currently reviewing the drug for licencing. NICE are also reviewing it for use on the NHS.

Iveric Bio have also recently gained approval in the USA for their drug Izervay, which has a similar action to Syfovre and is also an eye injection. It is being considered for approval in Europe and the UK.

It is important to note that the aim of both drugs is to slow the speed of deterioration. Neither claims to restore vision.

Biosimilars

When a drug’s patent expires it opens up the market to biosimilars. These are drugs that have a very similar make-up to the original drug, with no meaningful difference in how well they work or their safety. They are rigorously analysed and tested before being given a licence and give NHS clinicians choice and potentially significant cost savings.

So alongside Lucentis we now have the biosimilars Ongavia, Byooviz and Ximluci, with others in the pipeline. Biosimilars for Eylea are starting to become available as well and we now have Yesafili, a biosimilar to Eylea. You would not be switched to a biosimilar drug without your consent.

Stem cell therapy

This type of treatment for wet and dry AMD is still in early phase clinical trials. The two patients with wet AMD who were treated at Moorfields Eye Hospital in London in 2015 regained some vision and there have been no issues with safety. Work is ongoing and more patients are being recruited to the trial now.

In the USA there are two clinical trials underway for dry AMD which are showing promising early results. A trial of the treatment called Opregen has shown a few of those treated have regained some vision.

Gene therapy

This form of treatment is very new and uses genes to treat diseases. A harmless virus injected into the macula is able to carry a gene into the cells. The gene provides the code for making a drug, like Lucentis or Eylea. This enables the creation of a ‘drug factory’, as the eye can use the gene to make the drug itself, taking away the need for injections.

There are early phase clinical trials underway using gene therapy for wet AMD in the UK.

Research participant database

This is a register of people who are interested in hearing about opportunities to take part in research. You can sign up by filling in our Research participant database form or you can call 01264 322 419 to request a paper form.