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Emixustat not beneficial in managing geographic atrophy in AMD

05 Oct 2018

Treatment with emixustat does not appear to help reduce the growth rate of geographic atrophy in patients with age-related macular degeneration (AMD), according to the results of a phase IIb/III trial.

The trial randomized 503 patients with geographic atrophy secondary to AMD to treatment with emixustat 2.5 mg (n=133), 5 mg (n=134), 10 mg (n=103) or placebo (n=133), administered orally once daily for 24 months. Visual acuity score at baseline was 35 letters, while the total area of geographic atrophy was 1.25–18 mm2.

At 24 months, the primary endpoint of mean annual growth rate of total geographic atrophy area in the study eye, as measured using a central reading centre using fundus autofluorescence (FAF) images, did not significantly differ across the treatment groups (1.69–1.84 mm2/year with emixustat vs 1.69 mm2/year with placebo; p0.81).

Likewise, comparable results were obtained for the secondary efficacy endpoint of change from baseline in normal luminance best-corrected visual acuity. Of note, patients with a larger low luminance deficit (LLD) at baseline (≥20 letters) showed a more rapid growth of geographic atrophy over 24 months.

Growth rate of geographic atrophy was not associated with the risk-allele status of the AMD-associated single-nucleotide polymorphisms tested.

Commonly reported adverse events in emixustat-treated subjects were delayed dark adaptation (55 percent), chromatopsia (18 percent), visual impairment (15 percent) and erythropsia (15 percent).

The present data do not support modulation of the visual cycle by emixustat as an efficacious treatment strategy for geographic atrophy secondary to AMD, researchers said.

Additionally, the study confirms the natural history of geographic atrophy growth rate in a large population, as well as validates the association of this growth rate with baseline measures of geographic atrophy area, multifocal lesions, foveal atrophy, reticular pseudodrusen and LLD, researchers noted.

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Most Read Articles
6 days ago
A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.
5 days ago
Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.
3 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.
Pearl Toh, 4 days ago
Apixaban slashes the risk of recurrent venous thromboembolism (VTE) by 90 percent in cancer patients compared with the low-molecular-weight heparin (LMWH) dalteparin, with no increase in major bleeding risk, according to the ADAM VTE study presented at ASH 2018.