Pegcetacoplan Intravitreal Injection

How it works

It is a pegylated peptide that binds complement component C3 and its activation fragment C3b, inhibiting the complement cascade that contributes to the retinal cell loss underlying geographic atrophy and thereby slowing its progression.

Prescribing in practice

• As an intravitreal injection it carries a risk of endophthalmitis, intraocular inflammation and retinal detachment, and an increased rate of new-onset neovascular age-related macular degeneration has been observed with treatment.
• It slows progression of atrophy rather than restoring lost vision, so realistic expectations should be set with the patient.
• Injections must be administered under aseptic conditions by a trained ophthalmologist.

Monitoring

Patients should be monitored after each injection for intraocular inflammation, infection and signs of new choroidal neovascularisation.

Counselling the patient

• This treatment aims to slow further damage to the macula rather than improve current vision.
• Seek urgent care if you develop eye pain, increasing redness, light sensitivity or sudden visual change after an injection.
• Regular ongoing injections and reviews are needed to maintain the benefit.

Evidence & guidelines

Pegcetacoplan's ability to slow geographic atrophy progression was demonstrated in the OAKS and DERBY phase 3 trials and is reflected in its licensed indication.