For GA Treatment, the Earlier the Better

Early intervention for geographic atrophy may improve the chances of preserving healthy retinal tissue and visual function. Photo: Paul M. Karpecki, OD. Click image to enlarge. More evidence has emerged highlighting the benefits of initiating treatment for geographic atrophy (GA) earlier in the disease course. At the 2026 ARVO meeting in Denver last Monday, Maximillian Pfau, MD, of the University of Bonn in Germany, shared research his multi-institutional group performed on pegcetacoplan outcomes.To compare early and delayed treatment with intravitreal pegcetacoplan for geographic atrophy, the researchers analyzed data of patients who completed the 24-month OAKS/DERBY trials (which compared pegcetacoplan vs. sham) and continued into the 36-month GALE extension study on the same treatment interval. Those treated monthly or every-other-month comprised the early treatment group, while sham eyes from OAKS/DERBY that crossed over to active treatment in GALE made up the delayed treatment group.A total of 782 patients enrolled in the extension study, with 68% completing five years. In GALE, pegcetacoplan significantly reduced GA growth in eyes with subfoveal and nonsubfoveal GA by 27% in the monthly treatment group and 26% in the every-other-month treatment group. In nonsubfoveal GA, the drug reduced GA growth more than sham by 33% in the monthly treatment group and 30% in the every-other-month treatment group (between months 24 and 60).Eyes that received earlier treatment had better outcomes. In nonsubfoveal GA, GA growth was reduced by 31% with monthly injections, which preserved 3.87 mm2 of retinal tissue or nearly two disc areas. On the other hand, the delayed treatment group experienced GA growth reductions of 26% and 1.93 mm2 of preserved tissue.Five years of continuous therapy delayed GA progression in nonsubfoveal GA eyes by 18.5 months and 16.5 months with monthly and alternate-month treatment.The researchers pointed out that the safety profile of the three-year extension study was similar to that of the two-year OAKS/DERB study. Post-market reports of retinal vasculitis were rare (<1/4,000 per first injection). The researchers noted that since September 2025, about 800,000 injections have been administered in real-world settings and phase 3 programs.They concluded that the long-term efficacy and safety of pegcetacoplan in patients with GA secondary to AMD “highlight the importance of earlier treatment in GA.” Notably, they explained that therapy was “well-tolerated and generally acceptable to patients.”Original abstract ©2026 Association for Research in Vision and Ophthalmology.Click here for the source. Pfau M, Singh Dhoot D, Garg S, et al. Earlier treatment yields better outcomes: 5 years of pegcetacoplan treatment for geographic atrophy secondary to AMD. ARVO 2026 annual meeting. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.