Only SYFOVRE is approved for EOM dosing, demonstrating efficacy with as few as 6 doses per year^1,2

Helping Patients Stay Motivated for SYFOVRE Treatment

INDICATION

SYFOVRE® (pegcetacoplan injection) is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

SYFOVRE is contraindicated in patients with ocular or periocular infections, in patients with active intraocular inflammation, and in patients with hypersensitivity to pegcetacoplan or any of the excipients in SYFOVRE. Systemic hypersensitivity reactions (e.g., anaphylaxis, rash, urticaria) have occurred.

Please stay tuned for additional Important Safety Information and please see accompanying full Prescribing Information.

Helping Patients Stay Motivated for SYFOVRE Treatment

Hi, I'm Scott Walter. I'm a retina specialist based in Hartford, Connecticut.

I'm really excited about SYFOVRE because it's opened the possibility of treatment for our patients with Geographic Atrophy, or GA.

Today, I'm going to share some of my own insights, based on my early clinical experience with SYFOVRE, on how to help patients maintain their dosing schedule after we've selected a dosing interval and initiated treatment.

SET APPROPRIATE EXPECTATIONS

I've discovered that it's imperative to set accurate and realistic expectations right from the very beginning.

While SYFOVRE has been shown to slow the progression of GA, I want the patient to understand that it won't completely stop their GA lesion from growing.

Patients also need to understand that the effects of SYFOVRE are cumulative and can really only be measured over the long term. We can't expect to see measurable results after just one dose, but we do hope to see slowing of the lesion growth over spans of 1-2 years or longer.

By underscoring this point, we can avoid the patient coming back after one, or just a few injections, with a lot of questions about whether or not the treatment is working.

Before initiating treatment, I want to make sure my patients understand the limitations of short-term treatment and are committed to achieving a long-term goal. When we do this, we're setting our patients up for long-term adherence, which I think is really the most crucial element for treatment success with SYFOVRE.

Before I go into a detailed discussion of treatment with SYFOVRE with any patient, they must understand Geographic Atrophy, and what is likely to happen as the disease progresses. Unfortunately, the reality is that "the vision you have today is the best vision you're going to have for the rest of your life."

I tell patients with GA that the lesion is like a small pothole that's developing in the retina. It starts small and, over time, it gets larger and larger.

Unfortunately, each little pothole is associated with some permanent loss of retinal tissue and vision in that area. As the pothole gets bigger, it usually gets closer and closer to the center of your vision.

Unfortunately, most patients with GA will eventually experience severe visual impairment or even go blind from this condition.

I then explain that our goal with SYFOVRE treatment is to delay GA lesion growth as long as we can over the course of several years.

Using language that's appropriate to the patient's level of education and understanding, I explain that SYFOVRE has been shown to slow the progression of GA lesions over time. This was proven in a large clinical trial program that compared patients who were treated with SYFOVRE to those who did not receive treatment.

Sometimes my patients have done their own research and may have a good grasp of the SYFOVRE clinical trial data already. But more often than not, this is a conversation that takes place over multiple visits.

After introducing SYFOVRE, I send the patient home with a brochure and I give them an opportunity to go home and really digest what we've talked about in the clinic. If they come back with a lot of questions, I'll say, "OK, let's talk about some of these questions today, and we'll continue the conversation as we go along."

The SYFOVRE Prescribing Information includes efficacy data from the OAKS and DERBY clinical trials over 2 years. The reductions in lesion growth rates are shown here.

On average, untreated patients had lesions grow 0.7 to 0.9 millimeters squared more over 2 years when compared to patients treated with SYFOVRE every other month or monthly.

Patients treated with SYFOVRE had anywhere between 0.7 to 0.9 square millimeters of retinal tissue preservation.

This corresponds to a reduction of 18-22% in patients treated monthly and 17-18% in patients who were treated every other month with SYFOVRE.

I also tell patients that there are now longer-term results available from the ongoing SYFOVRE open-label extension study, known as GALE.

Before I show those results, I do go over some of the limitations of GALE:

The first 12 months of GALE used a projected sham which may not reflect all patients with GA.

Also, there is no statistical testing hierarchy, so the results require cautious interpretation.

I then show my patients the reduction in lesion growth rates with SYFOVRE in GALE, and the increasing effects over time that were observed through three years of SYFOVRE treatment, which you can see here.

I really think this helps patients understand why sticking with treatment over the long term is so important.

In discussion of any treatment with my patients, I always make sure to discuss any potential adverse events, or safety concerns.

CHOOSE PATIENTS WHO HAVE A LOT TO GAIN FROM SLOWED PROGRESSION

I generally prefer initiating treatment with SYFOVRE before there's much encroachment of the GA lesions on the central fovea, and before the patient has lost much central vision in that eye.

These patients in particular can be expected to have a longer lead time to vision loss and are more likely to benefit from the lesion growth rate reduction with SYFOVRE because of the increasing effects over time.

Often, patients who are most motivated for treatment are the ones who've already lost vision in one eye. Having actually experienced GA progression in one eye, they want to delay that outcome in their better-seeing eye if they can.

For those patients who are already experiencing some central vision loss due to GA, setting expectations is even more critical. I let these patients know that we can slow down the rate of GA progression, but the reality is, we're catching the disease relatively late.

I tell them that I wish SYFOVRE had been available for them two or three years ago, which would have been the ideal time to start treatment.

However, the clinical trials showed that SYFOVRE slowed GA lesion growth rates even for patients with subfoveal lesions, and we can expect that their rate of disease progression will be faster without treatment.

START TREATMENT WITH SUCCESS IN MIND

SYFOVRE is approved with a recommended dosing schedule of once every 25 to 60 days. This flexible dosing interval allows me to custom tailor my treatment plan to the individual needs of the patient, and work around potential scheduling conflicts.

When I start patients on treatment, I don't just book the next appointment. I tell the patient that they will have 3 appointments that we'll put on the calendar right away.

Getting the first 3 appointments scheduled up front helps the patient know what's coming, and it also helps me get those injections on the calendar, so my clinic doesn't have to try and squeeze the second or third injection into a fully booked schedule.

This way the patient has a chance to get accustomed to the injection procedure in a predictable way. It really helps them start on a positive note as they acclimate to treatment with SYFOVRE.

It's been my experience that when patients are prepared with a clear understanding of GA, and have realistic expectations about the effects of SYFOVRE treatment, that they will keep coming back for their injections over the long term.

INDICATION

SYFOVRE^® (pegcetacoplan injection) is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

• SYFOVRE is contraindicated in patients with ocular or periocular infections, in patients with active intraocular inflammation, and in patients with hypersensitivity to pegcetacoplan or any of the excipients in SYFOVRE. Systemic hypersensitivity reactions (e.g., anaphylaxis, rash, urticaria) have occurred.

WARNINGS AND PRECAUTIONS

• Endophthalmitis and Retinal Detachments
  • Intravitreal injections, including those with SYFOVRE, may be associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering SYFOVRE to minimize the risk of endophthalmitis. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately.
• Retinal Vasculitis and/or Retinal Vascular Occlusion
  • Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported with the use of SYFOVRE. Cases may occur with the first dose of SYFOVRE and may result in severe vision loss. Discontinue treatment with SYFOVRE in patients who develop these events. Patients should be instructed to report any change in vision without delay.
• Neovascular AMD
  • In clinical trials, use of SYFOVRE was associated with increased rates of neovascular (wet) AMD or choroidal neovascularization (12% when administered monthly, 7% when administered every other month and 3% in the control group) by Month 24. Patients receiving SYFOVRE should be monitored for signs of neovascular AMD. In case anti-Vascular Endothelial Growth Factor (anti-VEGF) is required, it should be given separately from SYFOVRE administration.
• Intraocular Inflammation
  • In clinical trials, use of SYFOVRE was associated with episodes of intraocular inflammation including: vitritis, vitreal cells, iridocyclitis, uveitis, anterior chamber cells, iritis, and anterior chamber flare. After inflammation resolves, patients may resume treatment with SYFOVRE.
• Increased Intraocular Pressure
  • Acute increase in IOP may occur within minutes of any intravitreal injection, including with SYFOVRE. Perfusion of the optic nerve head should be monitored following the injection and managed as needed.

ADVERSE REACTIONS

• Most common adverse reactions (incidence ≥5%) are ocular discomfort, neovascular age-related macular degeneration, vitreous floaters, conjunctival hemorrhage.

Please see accompanying full Prescribing Information.