Astellas Pharma Inc. has taken a significant step toward addressing an unmet medical need in Japan by submitting a New Drug Application (NDA) for avacincaptad pegol intravitreal solution (ACP) to the Ministry of Health, Labour and Welfare (MHLW). The application seeks conditional approval for treating geographic atrophy (GA) secondary to age-related macular degeneration (AMD), potentially marking the first available treatment option for Japanese patients with this condition.
Understanding the Disease Burden
Geographic atrophy represents a progressive form of AMD that leads to irreversible vision loss. The condition affects more than five million people globally, with approximately two-thirds of patients at risk of developing legal blindness or severe visual impairment without intervention. Currently, treatment options are extremely limited, with approved therapies only available in the United States and Australia.
"Today's submission comes as good news to people in Japan living with geographic atrophy who have no approved treatment options for this devastating disease," stated Marci English, Vice President, Head of BioPharma and Ophthalmology Development at Astellas.
Clinical Evidence Supporting the Application
The NDA submission draws from comprehensive clinical trial data, specifically the GATHER1 and GATHER2 studies. These randomized, sham-controlled trials evaluated monthly 2mg intravitreal administrations of ACP in GA patients. Key findings include:
- Demonstrated ability to slow GA lesion growth
- Favorable safety profile
- Sustained efficacy over a two-year follow-up period
- Consistent results across both GATHER1 and GATHER2 trials
Mechanism of Action and Treatment Approach
Avacincaptad pegol functions as a synthetic aptamer that targets and inhibits the complement C5 protein. This mechanism is crucial as overactivity of the complement system and C5 protein plays a significant role in the development and progression of GA. By modulating this pathway, ACP aims to decrease complement system activity and slow the degeneration of retinal cells.
Clinical Impact and Future Implications
The potential approval of ACP in Japan would represent a significant advancement in ophthalmology care. The treatment could offer hope to Japanese patients who currently lack therapeutic options for managing this progressive condition. The drug has already received approval in the United States under the brand name IZERVAY for treating GA secondary to AMD.
"If approved, avacincaptad pegol has the potential to be the first and only treatment to slow disease progression for eligible patients in Japan," English emphasized, highlighting the company's commitment to working with regulatory authorities to bring this treatment to patients.
