RWC 2024: An overview of real world geographic atrophy data

Durga Borkar, MD, MMCi, spoke with Modern Retina about the quality data (Qdata)gathered on geographic atrophy as well as the GATHER 1 and GATHER 2 data she presented at the 2024 Retina World Congress meeting in Fort Lauderdale, Florida.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Sydney M. Crago:

Hi, I'm Sydney Crago, editor of Modern Retina, and I'm here today with Dr. Durga Borkar to talk about geographic atrophy and the upcoming Retina World Congress.

Durga Borkar, MD, MMCi:

Hi, I'm Durga Borkar, I'm a vitreoretinal surgeon at the Duke Eye Center and a medical advisor to Verana Health. Thanks so much for having me.

Sydney M. Crago:

Yeah, so my first question for you today is going to be Verana Health partners with the American Academy of Ophthalmology IRIS Registry, the Intelligent Research In Sight, and I understand that several research projects taking place at Retina World Congress is centering around this IRIS Registry data. Can you explain a little bit about this partnership and how it works?

Durga Borkar, MD, MMCi:

Verana Health is the exclusive data curation and analytics partner of the American Academy of Ophthalmology, IRIS Registry or Intelligent Research In Sight, and through this partnership, Verana has access to a real-world data network of more than 80 million de-identified patients from more than 15,000 contributing clinicians. In utilizing its VeraQ population health data engine, Verana Health ingests and curates the real-world data from electronic health records to generate insights on a variety of ophthalmic conditions. I'm part of the medical team at Verana Health and serve as a medical advisor to provide oversight and clinical guidance alongside the team of data scientists here. The data is curated into quality data modules which Verana Health calls Qdata. These modules can help life science companies accelerate research and advance treatments for a variety of conditions including geographic atrophy, glaucoma, diabetic retinopathy, and more.

Sydney M. Crago:

Can you tell us a little bit about some of the Verana Health projects that will be featured at the Retina World Congress using this data?

Durga Borkar, MD, MMCi:

Of course! We have a few projects that are being featured this year. One of the key projects that we have is the FARETINA study, which is done in partnership with Genentech. And this is the largest real-world data study looking at real-world outcomes using faricimab for both neovascular AMD and diabetic macular edema. Additionally, we have a video abstract that discusses the real-world landscape of faricimab use and that includes the results from the FARETINA study. Another video abstract that we have is done in partnership with Bausch + Lomb. And this looks at outcomes after PDT therapy with visudyne, and this is done specifically in neovascular AMD patients who may potentially be refractory to anti-VEGF treatment. In this study, we looked at what happens to treatment intervals with anti-VEGF pre- and post-PDT with visudyne. And what we found was that PDT can serve as a great adjuvant therapy and decrease treatment burden for patients with intravitreal injections and neovascular age-related macular degeneration.

Sydney M. Crago:

What would you say are some of the most interesting findings from the FARETINA studies?

Durga Borkar, MD, MMCi:

That's a great question. You know, I think in the clinical trials, they primarily looked at treatment-naive patients. In the AMD studies, they only looked at treatment-naive patients, and then DME studies a predominance of patients were treatment-naive in clinical trials. So one of the most interesting things about FARETINA is looking at treatment patterns in the real-world. Specifically, in the real-world, we are primarily treating patients with faricimab for treatment experienced a majority of them are aflibercept 2 mg switchers. It's interesting to look at the results. We see that visual acuity remains stable in these treatment experience patients, but treatment interval increases again decreasing the treatment burden for patients. Additionally, the results are pretty notable for the treatment-naive patients, where we do see significant visual acuity gains. That's to be expected, because they're starting without any treatment on board. Additionally, there's been some interesting safety data to come from the FARETINA study that shows a very favorable safety profile, as expected and consistent with clinical trials.

Sydney M. Crago:

You will also be presenting at the event providing an overview of the GATHER 1 and GATHER 2 long-term study. Can you summarize some of these trials and the results that you'll be discussing?

Durga Borkar, MD, MMCi:

Yes, I'm really looking forward to presenting a long-term study overview of the GATHER 1 and GATHER 2 studies. These are 2 phase 3 randomized control trials, looking at the efficacy and safety of avacincaptad pegol or ACP the branded name is IZERVAY. And in these studies, we see that there is a significant reduction and geographic atrophy lesion size growth rate over time, when we look at how these lesions grow compared to sham. And in these studies patients are treated monthly with ACP and they're compared to at both 12 and 24 months in the long-term study overview, what we see is that the treatment effect of slowing GA lesion growth rate just amplifies over time, and is quite impressive at the 24 month mark.

Sydney M. Crago:

Related to geographic atrophy, can you provide some details on the Qdata geographic atrophy model?

Durga Borkar, MD, MMCi:

So I'll be presenting clinical trial results for drug that's now out on the market and available to patients. Now, it becomes important to understand its use in the real-world. And that's where the Qdata geographic atrophy module can come in. This is a data module that was created by Verana Health leveraging data from IRIS Registry. It can unlock new real-world research possibilities by linking EHR data and ophthalmic imaging data for a comprehensive view into the GA patient journey. The module provides access to curated variables such as visual acuity, subfoveal involvement, and more for more than 800,000 patients with geographic atrophy.

Sydney M. Crago:

Then, as a researcher and ophthalmologist, what type of approach are you seeing with geographic atrophy diagnosis and treatment?

Durga Borkar, MD, MMCi:

Sure, I think it's really an interesting time and geographic atrophy research and treatment, because for the longest time, we haven't had a treatment for geographic atrophy. So I think it's changed our discussions with patients. You know, for a long time, we really didn't follow a lot of these geographic atrophy patients in the retina clinic and IRIS Registry data suggests that. Many of these patients are with comprehensive ophthalmologists and optometrists. So [the] big change has been in referring these patients to retina specialists and having these initial conversations about the 2 treatments that are available. Additionally, talking to them about how we'll monitor them, how we'll reduce treatment burden for them; these are monthly injections that they have to come in for. So thinking about how we can really streamline their imaging visits and their injection visits to make this treatment as easy for them to tolerate as possible has become a main focus, and that was really something that we didn't think about a couple years ago.