What Do Retinal Specialists Think About Syfovre’s Retinal Vasculitis Side Effects, Switching Patients to Eylea HD and Other Hot Topics in Retina Medicine? | ASRS 2024

Syfovre (pegcetacoplan) or Izervay (avacincaptad pegol)? Vabysmo (faricimab) or Eylea (aflibercept)? Eylea in 2 milligrams (mg) or the new, high-dose, 8-mg version? Sell out to private equity or stay independent?

Retinal specialists have many choices and practice patterns vary.

ASRS 2024 attendees study the results from this year's survey of the membership. Approximately 40% of the members responded.

Results of the American Society of Retina Specialists’ (ASRS) annual survey of its members were posted at the ASRS annual meeting this week. Nearly 40% of the ASRS’ members filled out the survey and most of the questions had slightly more than 1,000 respondents. ASRS members who practice in the U.S. accounted for approximately 75% of the responses.

Here is a sample of the questions the survey asked and highlights of how the U.S. members responded.

What percentage of your geographic atrophy are your patients GA are you currently treating?

33.7% indicated between 1% and 10% of their patients, 10.9% indicated between 11% and 25%,and 6.5% indicated more than 25%. 17.4% indicated none because they do not believe the current therapies are warranted.

How have the reports of retinal vasculitis affected your current use of Syfovre?

15.7% indicated that the reports had no enduring impact on their utilization, 37.3% indicated that they had diminished their use of Syfovre because of the reports, 11.5% indicated that they had stopped using Syfovre because of the reports, and 27.7% indicated that they hadn’t treated patients with Syfovre because of the reports and don’t plan to.

How do (would) you incorporate Syfovre and Izervay for treating GA in your practice?

15.9% indicated that they would only incorporate Syfovre, 19.9% indicated that they would incorporate only Izervay and 37.2% indicated that they would incorporate both.20.5% indicated they would incorporate neither drug.

How would you manage an eye that develops wet AMD [age-related macular degeneration] during ongoing GA treatment?

34% indicated that they would stop GA injections and switch to injections for wet AMD,49.5% said they would inject GA and wet AMD on separate visits, and 5.8% said they would inject the GA and wet AMD treatment at the same visit.

Considering all indications, what is your most commonly used first-line anti-VEGF [vascular endothelial growth factor] agent?

55.1% indicated Avastin (bevacizumab), 31% indicated 2-mg Eylea, 8.8% indicated Vabysmo, 1.8% indicated Eylea HD (the 8-mg dose), and 3%, a biosimilar.

After a suboptimal response with Avastin for wet AMD, what is your next anti-VEGF choice?

61.2% indicated Eylea 2 mg, 27.7% indicated Vabysmo,5.1% indicated Eylea HD and 4.6%, a biosimilar.

After how many anti-VEGF injections for wet AMD do you consider switching agents due to inadequate response?

22.2% indicated after less than three injections and 75.6% indicated between three and injections.

Which IVT [intravitreal] injection delivers the best anatomic outcomes and disease control in wet AMD, DME [diabetic macular edema] and RVO [retinal vein occlusion]?

41.6% indicated Vabysmo, 38.8% indicated Eylea 2 mg, 14.2% indicated Eylea HD and 2.5% indicated Avastin.

Which factors are most important to you when selecting an anti-VEGF agent? (Select all that apply)

80.6% indicated ability to improve vision and maintain visual acuity gains, 80% indicated long-term safety profile supported by real-world data, 60.6% indicated the ability to achieve more-complete fluid resolution than the standard of care, and 42.6% indicated ability to achieve more-rapid fluid resolution than the standard of care.

Since the approval of Vabysmo, what benefits have you experienced in your treated patients?

71.1% indicated improved drying, 65.8% indicated extended durability of treatment, 21.5% indicated improved visual acuity and 13.3% indicated that they had not seen any benefit.

What do you think are the potential benefits of Eylea HD beyond the current standard of care?

70.5% indicated greater durability, 44% indicated improved treatment of recalcitrant patients, 43.3% indicated better drying effect and 15% indicated that they don’t see any benefit beyond the standard of care.

In the first year after approval of Eylea HD, how would you continue your use of Eylea (2 mg)?

41.9% indicated that they would switch mainly their “difficult-to-treat” patients from Eylea to Eylea HD, 25.3% indicated that they would switch a minority of their patients on a case-by-case basis, 13.5% indicated that they would switch most of their Eylea patients to Eylea HD and 12.9% indicated that they do not plan to switch patients.

Has a VC/private equity firm or hospital/health system recently shown interest in buying your practice?

29.9% indicated that they had been approached but have no interest in selling, 22.8% indicated that they have already sold their practice, 19.2% indicated that they haven’t been approached and have no interest and 4.4% indicated that they had been approached and are in the process of selling