What is Izervay?
The FDA approved Izervay for dry macular degeneration in August 2023. It is a new medication for the treatment of geographic atrophy caused by dry-type age related macular degeneration (AMD). Izervay is given by injection into the eye.
What is geographic atrophy?
Geographic atrophy is a common cause of loss of central vision in AMD. It occurs when retinal receptor cells die. It leaves blinds spots and missing areas in the vision. Until 2023, there was no treatment for geographic atrophy from AMD.
What does Izervay do?
Izervay blocks complement proteins (C5) in the body. Complement participates in the normal inflammatory response. And the inflammatory response is important to fight infection. However, in AMD the complement proteins contribute to the development of geographic atrophy and loss of vision.
How well does Izervay work?
Izervay is not a cure for dry AMD. Importantly, it does not reverse past damage by geographic atrophy. Izervay, when given by monthly injection, reduces the rate of worsening of geographic atrophy by 28% over 18 months of treatment as compared with sham injection. We anticipate this will delay blind spots from interfering with central vision.
What are the adverse effects of Izervay?
As with all intraocular injections there are risks. The risks involved with the introduction of a needle into the eye include bleeding, infection, and retinal detachment. These complications may require surgery and risk loss of vision.
Can Izervay cause wet macular degeneration to start?
The known risks of Izervay include the new occurrence of wet AMD with blood vessel growth threatening loss of vision. In the phase 2/3 study, wet AMD developed in 12% of eyes treated with Izervay compared with 3% in eye with sham injection over a period of 18 months. This represents a 400% increased risk of new-onset wet AMD. It is important to avert the development of wet AMD because the treatment of wet AMD involves routine, long-term injections of antiVEGF medications to prevent severe loss of vision.
What about the risk losing vision from infection?
There is a risk of infection (endophthalmitis) after any eye injection. At this time, we do not know if Izervay may increase the risk of developing infection or worsen the final vision after infection. The suppression of the natural defense against infection by Izervay, explains the concern over increased risk of infection with Izervay.
Should I receive Izervay injections?
If you have dry age-related macular degeneration with geographic atrophy, Izervay appears to delay the loss of central vision over time. However, long-term monthly injections are required. And you must carefully consider the risks of treatment. Your doctor will help you make this important decision.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.
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