Macular degeneration is the leading cause of blindness around the world – but a new, patient-led approach could mean a loss of sight is no longer inevitable.
Currently, there's no cure for most retinal diseases, Dr Victor Chong explains, but he and his team are working to change that. “We've got a portfolio of therapies in trial, looking at several areas – and the one we’re most interested in is called age-related macular degeneration (AMD).”
AMD is separated into two big groups – wet macular degeneration and geographic atrophy. Victor and his team oversee the trials targeting both areas. And while the latter is untreatable, the wet form of AMD already does have a treatment – an injection administered every four to eight weeks into the eye.
Victor says the percentage of those going blind from wet AMD dropped from 100% to 50% when the treatment was first introduced. But then the numbers stalled. It was a conundrum – the drug had fared well in trials, but people were still going blind in the real world. So, what was the stumbling block?
Identifying the problem
The answer was the real world. Victor explains, “If you think about our average patient, they’re in their seventies or eighties. You ask them to attend a hospital appointment. Usually, they’ll need someone to go with them to help them get home after the injection.”
“Then each visit can take two or three hours due to hospital wait times. So, once you account for all the toing and froing, that’s a whole day gone. I think for that reason a lot of patients don't really like going in.”
There are other medical factors to consider too, as older patients are often in their eighties and may have other health complications which could lead to the cancellation of an appointment. “With hospitals being so busy, they’re not that flexible. It could then take another month or two to get another appointment,” admits Victor.
“So, although you're supposed to have six or seven injections a year, a lot of people only get three or four. And some only get one or two. So just like any other treatment, if you don't get the full course, then your results won’t be as good. And when the results aren’t so good, some patients stop going. It becomes a vicious circle.”
“If you don't get the full course, then your results won’t be good. And when the results aren’t good, patients stop going. It’s a vicious circle.”
The new trials are designed to find a solution that’s more manageable for patients. “The first step is to try to extend the treatment interval to three times a year. It doesn’t sound like a revolutionary change, but it will help patients to keep appointments.”
And the other portfolio of therapies in trial? One is testing a medicine that only needs to be administered once a year, another working to prevent people developing wet AMD in the first place, while a third is developing a treatment for geographic atrophy. “That’s something that currently doesn’t exist at all,” says Victor. Screening programs to identify geographic atrophy earlier are also an avenue of interest.
“We are one of very few companies in the retinal field talking about treating the disease this early.”
“We are one of the very few companies in the retinal field that is talking about treating the disease this early. Other scientists are still focusing on established areas of retinal research, but we’ve already moved on.“