Overview

Should I Treat This Patient With Geographic Atrophy? Weighing Benefits and Burden of Treatment With Complement Inhibitors

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Format

Clinical Commentary

Time to Complete

1.50 hr(s).

Release Date

May 30, 2025

Expires On

May 30, 2026

Geographic atrophy (GA) is a progressive disease that can cause blindness and loss of independence. Recent advances in imaging and the approval of pharmacologic therapies targeting the complement cascade have created new opportunities to slow disease progression; however, these therapies are associated with an increased risk of neovascular complications and unanswered questions about which patients should be treated. To help specialists interpret and apply the growing body of evidence in patient selection practices, this point-counterpoint digital activity uses case-based discussions to frame differing perspectives around complex clinical questions, helping learners critically review the risk-benefit profiles of novel agents and optimally select GA patients who may qualify for treatment with the new complement inhibitors.

Through the point-counterpoint exchange, faculty will discuss the following:

• Which patients could benefit from complement inhibition?

• Are there predictive factors that can inform personalized medicine?

• Has the efficacy of complement inhibitors been sufficiently demonstrated?

• What unanswered questions remain about efficacy and safety of the complement inhibitors?

• How should treatment response and adverse reactions be monitored?

• What are the implications of treatment for patients who have yet to significantly progress, and what are the potential concerns?

• Based on available evidence, when should patients be treated with complement inhibitors and for how long?

This program is intended for eye care specialists who treat geographic atrophy.

Geographic atrophy (GA) is a form of advanced, nonexudative (dry) age-related macular degeneration (AMD) that results in severe impairments to visual fields and visual acuity due to scotomata. Vision loss due to GA is associated with substantial impairments to daily functioning and quality of life, with an increased risk for falls and loss of independence that may require long-term care due to inability to read, recognize faces, eat, dress, and work. Consequently, establishing an accurate diagnosis of GA is important for counseling patients about expected disease progression and modifiable risk factors, providing an opportunity to intervene earlier to potentially slow disease progression. In addition, there is new hope for patients with GA, with two novel therapies recently approved for the treatment of the disease. However, there are no guidelines at this time to provide recommendations about the use of these therapies and there are many questions about which patients may benefit. To ensure that eye specialists are prepared to prescribe these therapies to appropriate patients, it is essential that they evaluate clinical safety and efficacy data for application in routine clinical practice and receive expert guidance on a variety of issues including patient selection considerations, setting expectations, managing adverse events, and timing and duration of treatment.

Upon completion of this activity, learners will be able to:
• Describe the pathophysiologic processes contributing to geographic atrophy (GA) development and progression
• Outline the clinical and patient factors associated with treatment decision-making
• Critically review clinical trials and discuss opportunities to apply evidence on complement inhibition for GA

Provided by the University of Chicago Pritzker School of Medicine and the Academy for Continued Healthcare Learning (ACHL).

Supported by an educational grant from Astellas.

Carl D. Regillo, MD, FACS (Chair and Moderator)
Mid Atlantic Retina, Wills Eye Hospital
Thomas Jefferson University
Philadelphia, PA

Lejla Vajzovic, MD, FASRS (Discussion Panelist)
Director, Duke Surgical Vitreoretinal Fellowship Program
Co-Director, Duke Pediatric Retina and Optic Nerve Center
Director, Duke Eye Center Continuing Medical Education
Professor of Ophthalmology
Duke University Eye Center
Durham, NC

Xiao Yi (Ellie) Zhou, MD (Discussion Panelist)
Assistant Professor of Ophthalmology and Pathology
University of Chicago Medicine
Chicago, IL

As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone in a position to control the content of an education activity to disclose all financial relationships with any ineligible companies. This includes any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Financial relationships are relevant if a financial relationship, in any amount, exists between the person in control of content and an ineligible company during the past 24 months, and the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. Mechanisms are in place to identify and mitigate any relevant financial relationships prior to the start of the activity.

Additionally, The University of Chicago Pritzker School of Medicine requires Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration at first mention and where appropriate in the content.

The following financial relationships have been provided:

Carl D. Regillo, MD, FACS

Consultant: 4DMolecular Therapeutics, Adverum, Allergan, Annexon, Apellis, Aviceda, Bausch and Lomb, Clearside, Cognition, EyePoint, Genentech, Iveric, Janssen, Kodiak, Lineage, Merck, NGM Bio, Novartis, Ocugen, Ocuterra, Occuphire, Opthea, Ray Pharmaceuticals, RegenXBio, Stealth, Thea Pharma Inc., Zeiss, ZipBio

Research and grant support: 4DMolecular Therapeutics, Adverum, Allergan, Annexon, Apellis, Astellas, EyePoint, Genentech, Gyroscope, Iveric, Janssen, Kodiak, Lineage, NGM Bio, Notal, Novartis, Ocugen, Ocuterra, Opthea, Regeneron, RegenXBio, Stealth

Lejla Vajzovic, MD, FASRS

Consultant/Advisor: Abbvie, Allergan, Adverum Biotechnologies, Inc., Alcon, Inc., Alimera Sciences, Alkeus Pharmaceuticals, Inc., Appellis, Astellas, Baush & lomb, BioCryst, Beaver-Visitec International, Bryn Mawr Communications, Clearside Biomedical, Coherus Biosciences, Direct Optical Research Company, Evolve Medical Education, Guidepoint, Gyroscope Therapeutics, Inveric Bio, Janssen, Johnson & Johnson, Lexitas, Nanoscope Therapeutics, Inc., Novartis, Ocugen Inc., Ocular Therapeutix, Oculus Surgical, OcuTerra Therapeutics, ONL Therapeutics, Outlook Therapeutics, Inc., Regeneron, Regenxbio Inc., Roche/Genentech, Vindico Medical Education

Grant Support: Abbvie, Allergan, Alcon, Inc., Applied Genetic Technologies Corporation (AGTC), Alcon, Inc., Aldeyra Therapeutics, Inc., Appellis, Gyroscope Therapeutics, Heidelberg Engineering, Janssen, Johnson & Johnson, National Eye Institute, Novartis, Ocugen Inc., Ocular Therapeutix, Optos, Regenxbio Inc., Roche/Genentech,

Patents/Royalty: Alcon, Inc.

Xiao Yi (Ellie) Zhou, MD

No financial relationships to disclose

The University of Chicago Pritzker School of Medicine, ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

All of the relevant financial relationships listed for these individuals have been mitigated.

The content for this activity was developed independently of any ineligible company. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor(s).

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL and The University of Chicago requires the speaker to disclose that a product is not labeled for the use under discussion.

Discussion of scientific information on unapproved uses (SIUU), off-label, investigational, or experimental drug/device use: ANX007, IONIS-FB-LRx, elamipretide, risuteganib, FHTR2163, GT005, and cell-based therapies are not approved for the treatment of geographic atrophy.

To receive credit, learners are required to complete the pretest, view the online activity, and complete the posttest and evaluation. To receive credit, 75% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Chicago Pritzker School of Medicine designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician assistants, nurse practitioners, and nurses may participate in this educational activity and earn a certificate of completion as AAPA, AANP, and ANCC accept AMA PRA Category 1 Credits™ through their reciprocity agreements.

Karen Catino
kcatino@achlcme.org

Overview

Should I Treat This Patient With Geographic Atrophy? Weighing Benefits and Burden of Treatment With Complement Inhibitors

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