PUBLISHER: DelveInsight | PRODUCT CODE: 1442055
PUBLISHER: DelveInsight | PRODUCT CODE: 1442055
DelveInsight's " Dry AMD - Market Insights, Epidemiology, and Market Forecast - 2034" report delivers an in-depth understanding of dry AMD, historical and forecasted epidemiology as well as the dry AMD market trends in the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan.
The dry AMD market report provides current treatment practices, emerging drugs, dry AMD market share of individual therapies, and current and forecasted dry AMD market size from 2020 to 2034, segmented by seven major markets. The report also covers current dry AMD treatment practices/algorithms and unmet medical needs to curate the best of the opportunities and assess the underlying potential of the market.
Study Period: 2020-2034
Dry AMD Overview
By 1965, the terminology surrounding AMD had gained widespread acceptance, with the condition classified into three clinical stages: early, intermediate, and advanced AMD. The earliest clinical sign of early AMD is the presence of drusen (>63 and =125 ?m in diameter), which hampers the patient's ability to adapt to changes in illumination. However, the most substantial central visual loss occurs in the intermediate and advanced stages, with advanced AMD encompassing geographic atrophy and neovascular AMD. Geographic atrophy is characterized by a gradual deterioration of the macular RPE, photoreceptor layer, and choroidal capillaries, resulting in progressive vision loss over time. Diagnosis requires thorough eye examinations, and management strategies focus on slowing disease progression and optimizing remaining vision. Despite efforts, a cure for advanced dry AMD remains elusive, emphasizing the critical need for ongoing research to develop effective treatments for this debilitating condition.
Dry AMD Diagnosis
Diagnosing dry AMD typically involves a comprehensive eye examination, during which an ophthalmologist or optometrist evaluates the retina for characteristic signs of the condition. These signs may include the presence of drusen, small yellow deposits beneath the retina, and changes in pigmentation. Advanced imaging techniques such as optical coherence tomography (OCT) and fundus autofluorescence imaging may also be employed to assess the extent of retinal degeneration. Early detection is crucial in managing dry AMD, as it allows for timely intervention to slow disease progression and preserve vision.
Further details related to diagnosis will be provided in the report.
Dry AMD Treatment
People with dry AMD typically experience impaired central vision but often retain peripheral vision, allowing them to perform many daily activities. While there is no cure for AMD, treatment options aim to slow down the progression of the disease and preserve vision. Studies suggest that supplements containing vitamins C and E, lutein, zeaxanthin, zinc, and copper may help slow the progression of dry AMD. Ongoing clinical trials are exploring various therapeutic approaches, including complement pathway inhibitors, visual cycle modulators, antioxidative therapy, neuroprotective agents, and stem cell therapy, among others. Complement pathway inhibitors show promise in reducing geographic atrophy progression, while stem cell therapy aims to restore retinal function. These advancements offer hope for improved management and potential restoration of vision in individuals with dry AMD.
Until recently, there were no proven therapies for geographic atrophy. In 2023, the US FDA approved SYFOVRE (in February) and IZERVAY (in August) for slowing the progression of lesions of geographic atrophy. While IZERVAY or SYFOVRE injections can slow down disease progression, it is important to note that they cannot reverse the effects or restore lost vision.
Further details related to treatment will be provided in the report...
The dry AMD epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by the total prevalent cases of AMD, stage-specific prevalent cases of AMD, total prevalent cases of geographic atrophy, total prevalent cases of dry AMD, total diagnosed prevalent cases of dry AMD, age-specific cases of early and intermediate AMD, age-specific cases of geographic atrophy, geographic atrophy cases by visual impairment in the 7MM market covering the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan from 2020 to 2034.
The drug chapter segment of the dry AMD report encloses a detailed analysis of the late-stage (Phase III ) and mid-stage (Phase II/III and Phase II) pipeline drugs. The current key players include Belite Bio (Tinlarebant), Alkeus Pharmaceuticals (ALK-001), Stealth BioTherapeutics (Elamipretide), Annexon Biosciences (ANX007), AstraZeneca/Alexion Pharmaceuticals (Danicopan), Ionis Pharmaceuticals/Roche (IONIS-FB-LRx), Regenerative Patch Technologies (CPCB-RPE1), Lineage Cell Therapeutics/Roche (OpRegen), Johnson & Johnson Innovative Medicine (JNJ-1887), and others.
The drug chapter also helps understand the dry AMD clinical trial details, pharmacological action, agreements and collaborations, approval, and patent details, and the latest news and press releases.
Marketed Drugs
IZERVAY (avacincaptad pegol): Astellas Pharma/Iveric Bio
IZERVAY, also known as avacincaptad pegol is designed to target and inhibit complement factor C5. Complement factor C5 is a central component of the complement cascade and is believed to be involved in the development and progression of dry AMD. IZERVAY binds to C5 and inhibits its cleavage into the terminal fragments C5a and C5b. By inhibiting the formation of complement system terminal fragments, IZERVAY may decrease the activation of inflammasomes and the formation of membrane attack complexes (MAC), which occur at the end of the complement cascade. In August 2023, the US FDA approved IZERVAY for the treatment of geographic atrophy secondary to AMD. Concurrently, Astellas Pharma announced that the European Medicines Agency (EMA) has accepted Iveric Bio's MAA for avacincaptad pegol for the treatment of geographic atrophy secondary to AMD.
SYFOVRE (pegcetacoplan): Apellis Pharmaceuticals
SYFOVRE is a targeted C3 inhibitor designed to regulate excessive complement activation, which can lead to the onset and progression of many serious diseases. Pegcetacoplan is a type of synthetic cyclic peptide conjugated to a polyethylene glycol polymer that binds specifically to C3 and C3b. The company is evaluating pegcetacoplan in several clinical studies, including paroxysmal nocturnal hemoglobinuria (PNH), geographic atrophy (GA), cold agglutinin disease (CAD), warm antibody autoimmune hemolytic anemia (wAIHA), complement-dependent nephropathies (CDN). SYFOVRE is the first and only approved therapy for geographic atrophy secondary to AMD. In January 2024, the CHMP of the EMA adopted a negative opinion on the MAA of intravitreal pegcetacoplan for the treatment of geographic atrophy secondary to AMD.
Emerging Drugs
Iptacopan (LNP023): Novartis
Novartis Pharmaceuticals is developing Iptacopan, an oral small-molecule inhibitor of complement factor B (FB) with potential immunomodulatory activity. Upon administration, FB inhibitor LNP023 binds to FB and prevents the formation of the alternative pathway (AP) C3-convertase (C3bBb). This limits the cleavage of C3 to the active fragment C3b and may prevent C3b-mediated extravascular hemolysis in certain complement-driven disorders such as intermediate age-related macular degeneration (iAMD), C3 glomerulopathy (C3G), paroxysmal nocturnal hemoglobinuria (PNH), etc. Recently, in December 2023, the US FDA approved FABHALTA (ipatocan) as the first oral monotherapy for adults with paroxysmal nocturnal hemoglobinuria (PNH) (Novartis, 2023). Currently, the company is investigating iptacopan in the Phase II trial (NCT05230537) for the treatment of patients with early and intermediate age-related macular degeneration.
ALK-001: Alkeus Pharmaceuticals
Allegro Ophthalmics is developing risuteganib (also known as ALG-1001), a breakthrough integrin-regulating therapy for ocular health that reduces mitochondrial dysfunction involved in intermediate dry AMD. By targeting multiple pathways, risuteganib helps reduce the cellular burden of oxidative stress and restores retinal homeostasis. Research suggests that risuteganib interferes with integrin functions that have been implicated in retinal diseases, giving it the potential for a broad-spectrum effect on different pathways of oxidative stress. Currently, the company has received the US FDA agreement under Special Protocol Assessment (SPA) for Phase IIb/III clinical trial of risuteganib for the treatment of intermediate, non-exudative age-related macular degeneration (dry AMD). Moreover, the overall protocol design of Phase IIb/III dry AMD clinical trial was finalized by the US FDA.
Drug Class Insight
Integrin Inhibitor
Integrin inhibitor have been effective in several preclinical models, and promising results have been reported thus far from clinical trials. Indeed, most of the current avB3 clinical investigations centre on treating eye diseases (age-related macular degeneration (AMD) using topically dosed or intravitreally injected small molecules and peptides, although these molecules also inhibit other av integrins and/or a5B1 to varying degrees. The molecules that have progressed the furthest in the clinic are risuteganib (Luminate, Allegro Ophthalmics). It is a small peptide integrin regulator protecting cells of the human RPE against dysfunction related to oxidative stress. With age, decreased mitochondrial oxidative phosphorylation increases the generation of reactive oxygen species and decreased metabolic activity, thus negatively affecting cellular bioenergetics and mitochondrial functioning. It is also known that RPE mitochondrial dysfunction contributes to the oxidative stress causing AMD.
Complement C5 inhibitors
Complement C5 inhibitors target the complement cascade, a part of the immune system involved in inflammation and tissue damage. By inhibiting C5, these drugs help mitigate the inflammatory response and prevent further damage to retinal cells. Additionally, complement inhibition may also have a protective effect on neighboring healthy cells, preserving overall retinal function.
In the advanced stages of dry AMD, complement C5 inhibitors play a crucial role in addressing the underlying inflammatory processes that contribute to disease progression. Dry AMD, particularly in its advanced form known as geographic atrophy, is characterized by the gradual degeneration of retinal cells, leading to vision loss. Research indicates that complement dysregulation and chronic inflammation play significant roles in the pathogenesis of AMD.
Geographic atrophy, the advanced stage of dry AMD, has emerged as a prominent focus of research. Current investigations predominantly center on therapies targeting complement inhibitors of C3 and C5, pivotal factors in triggering inflammation and subsequent cell death within the eye. Extensive studies led by the National Eye Institute and esteemed researchers globally have unveiled the likelihood of an overactive complement system as a central player in the genesis of dry AMD and its evolution toward GA.
Enhancing comprehension of the pathophysiology of geographic atrophy resulting from dry AMD can benefit patients, optometrists, and ophthalmologists alike. This improved understanding could lead to more accurate identification and diagnosis of patients, potentially lessening the burden of the disease and extending their visual function over time.
The landscape of research and development in intermediate AMD has shifted to dry AMD, exemplified by Stealth Biotherapeutics redirecting its focus toward dry AMD. As seen in Elamipretide, a mitochondria-targeting antioxidant, has progressed to Phase II trials for dry AMD following promising outcomes in Phase I trials for intermediate AMD.
Immune response-targeting agents have emerged as the most advanced area of clinical research for geographic atrophy, marking a significant milestone as the first and only drug class to enter the market to date. The FDA approvals of IZERVAY (avacincaptad pegol) and SYFOVRE (pegcetacoplan) represent groundbreaking developments. Both medications have demonstrated their ability to effectively slow down the progression of geographic atrophy, thereby mitigating vision loss. These approvals signal a transformative shift in clinical practice, research priorities, investment decisions, and healthcare planning. While these breakthrough medications provide hope for individuals with late-stage dry AMD, they signify just the initial steps in advancing treatment options for geographic atrophy.
Numerous therapies are currently undergoing investigation to slow the progression of geographic atrophy and maintain macular function in patients with dry AMD. These potential treatment options in clinical trials, with a focus on disease prevention and halting disease progression, include ALK-001, Elamipretide, Risuteganib, EG-301, ANX 007, IONIS-FB-LRx, NGM 621, JNJ-1887 (AAVCAGsCD59), among others
Detailed market assessment will be provided in the final report.
Key Findings
This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2024-2034. The landscape of dry AMD treatment has experienced a transformation with the uptake of novel drugs. These innovative therapies are redefining standards of care. Furthermore, the increased uptake of these transformative drugs is a testament to the unwavering dedication of retinal physicians, ophthalmologists, professionals, and the entire healthcare community in their tireless pursuit of advancing eye care. This momentous shift in treatment paradigms is a testament to the power of research, collaboration, and human resilience.
Dry AMD Pipeline Development Activities
The report provides insights into therapeutic candidates in Phase III, Phase II/III,and Phase II. It also analyzes key players involved in developing targeted therapeutics. Companies like Belite Bio, Alkeus Pharmaceuticals, Novartis and Allegro Ophthalmics actively engage in late and mid stage research and development efforts for dry AMD. The pipeline of dry AMD possesses potential drugs. However, there is a positive outlook for the therapeutics market, with expectations of growth during the forecast period (2024-2034).
Pipeline Development Activities
The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for dry AMD emerging therapy.
KOL Views
To keep up with current market trends, we take KOLs and SMEs' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts contacted for insights on the dry AMD evolving treatment landscape, patient reliance on conventional therapies, patient therapy switching acceptability, and drug uptake, along with challenges related to accessibility, including Retinal Specialist, ophthalmologist, eye specialist, and others.
DelveInsight's analysts connected with 30+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. Centers such as the Institute for Saint John's Health Center in California, Byers Eye Institute, McPherson Eye Research Institute, Retina specialist at Providence Saint John's Health Center, Department of Ophthalmology, Ophthalmic Consultants etc., were contacted. Their opinion helps understand and validate current and emerging therapy treatment patterns or dry AMD market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.
Qualitative Analysis
We perform Qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and Analyst views. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.
Market Access and Reimbursement
Referring patients with wet AMD to a retina specialist is common practice, but for patients with intermediate AMD, optometrists may feel that their options are limited. These patients require frequent monitoring to watch for the development of wet AMD. The current standard of care used by some eye care practitioners includes sending patients home with an Amsler grid and instructing them to use the grid every day to monitor their vision and report back to them with any changes in their vision. Although many optometrists still rely on the Amsler grid, clinical experience and research have shown that these and other high-risk patients often fail to use the Amsler grid between office visits to catch the earliest signs of neovascularization.
IZERVAY Patient assistance program is designed to meet the unique needs of eligible patients. Whether patients have commercial insurance, insurance that does not cover IZERVAY, are uninsured, or have government-issued insurance (such as Medicare), help may be available.
IZERVAY VisionPoints is a free patient engagement and educational support program for people to learn about GA and treatment with IZERVAY. IZERVAY VisionPoints is available to residents of the United States and Puerto Rico only. Health information is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. A prescription for IZERVAY is not required to participate in the IZERVAY VisionPoints program. Gift cards are limited to no more than USD 15 each, with an annual maximum of USD 75 per year. Void where prohibited by law.
Detailed market access and reimbursement assessment will be provided in the final report.
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