Dr Charles Wykoff: Some Patients May Need Both Gene Therapy and Anti-VEGF to Treat Wet AMD

While there are benefits of gene therapy, some patients will continue to need anti–vascular endothelial growth factor (VEGF) therapy to treat wet age-related macular degeneration, said Charles C. Wykoff, MD, PhD, director of research at Retina Consultants of Texas; chair of research, Retina Consultants of America; and deputy chair of ophthalmology for the Blanton Eye Institute, Houston Methodist Hospital.

Transcript

What are the benefits in outcomes of using gene therapy over anti-VEGF injections in wet age-related macular degeneration?

We've had anti-VEGF injections now for over 15 years. And thank goodness we've had them. We've been able to really change the epidemiology of blindness around the world because of them. I don't see a gene therapy like this replacing the need for intravitreal injections. I mean, this gene therapy is only being utilized in these trials among patients who are previously treated. It's really important to demonstrate responsiveness before you give someone a potentially one-and-done therapy, like a gene therapy. You want to make sure that they're anti-VEGF responsive. And then certainly some patients will be good candidates for gene therapy, and others may not.

I think that a gene therapy like this is going to be very clinically useful and valuable for many patients. But some patients will continue to receive anti-VEGF bolus injection monotherapy. Even among the patients that can get gene therapy, we're seeing that a that a that a minority of patients, but a meaningful minority—27% to 40% of eyes—are receiving ongoing anti-VEGF injections after the gene therapy treatment. The hope is that many patients will not need ongoing therapy, repeated bolus injections, but some patients will. It's going to be sort of a hybrid model depending on each patient's responsiveness to the gene therapy when this is available commercially.