Advances in the Management of Geographic Atrophy - Episode 7

Patient and Provider Perspective on Geographic Atrophy Therapies

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Veeral Sheth, MD, MBA, discusses how clinicians are beginning to use these therapies and the patient reaction to the availability of treatments for GA.

Veeral Sheth, MD, MBA: We've had SYFOVRE out for a little bit, and IZERVAY fairly recently, we're still trying to figure out who the right patient is for these treatments. And, not just that, but what the right dosing protocol is, what the follow-up is for these patients, and how to continue to refine how we counsel these patients. If there's a question about, what's the consensus, is one treatment preferred over the other? The answer is, it's way too early to tell. I think that we're still just starting to understand how to use these treatments. And I think that will come with real-world data, real-world evidence, and feedback from our patients. That's going to help us refine, not only who we offer this to, but maybe how we offer it, and what that routine is going to end up looking like.

I think we saw that with wet AMD. When we had our first treatments, back in 2005, 2006, we didn't really know how to talk to patients about it, how to treat patients with it, or how it was going to affect our clinic flows. And it took a few years probably to figure out where that would go. And even in wet AMD, we're still refining how we treat, we went from monthly to maybe pro re nata to now the majority of providers using treat-and-extend. Not that that's going to be the exact way we look at this, but I think there's still a lot we're going to learn in how we approach this. Even as an individual physician, if you have a preference for one treatment over another.

I think again, it's way too early to say, maybe a year from now or two years from now, as we continue to collect real-world data, we may be able to answer that question a little better. For the most part, I think patients have been pretty excited about the fact that we can treat this type of macular degeneration. I'll tell you that, I think this year more than any I've had patients proactively asking me about therapies. And I think some of that has to do with the fact that there's direct-to-consumer marketing that's happening, and in a much kind of broader sense than maybe we've seen in the past. I think because of that, there's this awareness of both geographic atrophy as a disease. I mean, people are coming in specifically asking about GA, which, you know, I think that that's very new for us. And then they're coming in knowing about certain therapies and, and that the fact that there is a treatment option, and so they're asking about it.

In general, patients are pretty excited about it, when you start to get into the details with patients, here's what it takes to treat this, and here's what the expectation is, from a treatment standpoint. I would say the enthusiasm is a little more tempered because then reality starts to hit like, oh, boy, I need to come in every month or two and get a shot in the eye. And then that reality starts to set in. And I think we see two groups of patients, we see some that are gung ho, they want to do it, they want to dive right in. And then I see some patients that are a little more reserved, hey, maybe let's see what happens over the next few months, let's get a better idea of what's happening to patients before I jump in. Then maybe there's a third group that is super excited at the very beginning, they start getting treatment.

And then the enthusiasm wears off a little bit when they realize that their vision isn't changing much and I don't know if the impact of the treatment is as obvious to them. And I think that tempers their enthusiasm a little bit. And then, we have to kind of reinforce the rationale of treatment and why we're treating. And most of those patients will continue on at least from what we've seen, will continue on with therapies, but I'm sure some will say I'm tired and I don't want to do it. So again, this kind of all goes back to the fact that it's new. We're still learning. But I think overall, there is excitement, especially from the patient standpoint, because there's an option for the first time that didn't exist with this disease.