Rishi P. SIngh, MD: Advances and Challenges in Neovascular AMD Treatment


Dr. Singh discusses the aging population in ophthalmology care, advances including port delivery systems, and the potential rapid uptake of faricimab in treatment.

In the second part of an interview with HCPLive, Rishi Singh, MD, Cole Eye Institute, Cleveland Clinic, continued his discussion on his paper “Faricimab in Neovascular AMD: Primary Results From the Phase 3 TENAYA and LUCERNE Trials”, presented at the American Academy of Ophthalmology 2021 Meeting.

Singh noted that the results of the paper have significant implications in regards to an older population, pointing out ophthalmology as the second most geriatric specialty other than geriatrics.

He also noted the risk factors for neovascular AMD may also be due to lifestyle issues with regards to smoking, high fatty diets, sun exposure, and so on, expecting to see the numbers of the disease to increase significantly the next few years due to these factors.

“With longevity continuing, we're seeing a higher rate of conversion to both geographic atrophy which is the end stage form of dry macular degeneration, as well as the formation of neovascular AMD which is obviously concerning and debilitating for many people that are involved,” he said.

Additionally, Singh shared his perspective on port delivery systems (PDS) as a new advent to surgical options for the treatment of neovascular retina diseases on a sustained basis, noting the recent approval of PDS with ranibizumab for the treatment of neovascular AMD.

“If you look at the data, it's very convincing to show that 80% of patients were able to achieve a six month interval or even greater, and if you in the time to median refill was out around 13 or 14 months,” he said. “That tells us that there's a lot of durability here with regards to the drug's ability to really suppress VEGF related diseases long term.”

He noted that while PDS with ranibizumab may require increased training and education, to reduce the risk of endophthalmitis, he expects the uptake of faricimab to be a faster process.

“I think that that uptake is going to be very rapid with regards to faricimab and our population because clearly we're gonna see a lot of benefit with regards to the drying ability and the durability that we've seen in the studies thus far,” Singh said.

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