Izervay for treating geographic atrophy in age-related macular degeneration

Izervay (avacincaptad pegol) is a medication delivered by intravitreal injection primarily used to treat geographic atrophy (GA), a progressive eye condition related to age-related macular degeneration (AMD). This treatment helps slow the progression of GA, a condition causing loss of retinal cells and leading to vision impairment.

Izervay is indicated for the treatment of geographic atrophy secondary to age-related macular degeneration in adults. It is administered directly into the eye (intravitreal injection) to each affected eye and is intended for patients diagnosed with this specific progressive retinal disease.

avacincaptad pegol; avacincaptad pegol sodium; avacincaptad pegol sodium phosphate, dibasic, heptahydrates; sodium phosphate, monobasic, monohydrates; sodium chloride

Izervay is a complement inhibitor that works by blocking part of the immune system called the complement pathway, which is involved in the damage to retinal cells seen in geographic atrophy associated with AMD. By inhibiting this pathway, Izervay aims to reduce inflammation and slow degeneration of retinal tissue.

The recommended dose of Izervay is 2 mg (0.1 mL of the 20 mg/mL solution) administered via intravitreal injection into each affected eye approximately once every 28 ± 7 days (monthly).

The injection must be performed by a qualified physician using aseptic technique under controlled conditions, including sterile gloves, drapes, and eyelid speculum. Adequate anesthesia and a broad-spectrum topical microbicide should be applied prior to injection.

The procedure involves careful preparation: the vial is allowed to reach room temperature (20–25°C) before use, inspected for clarity (clear to slightly opalescent, colorless to slightly yellow), and drawn using a sterile filter needle and syringe provided in the kit. The exact 0.1 mL dose should be administered slowly into the vitreous cavity.

Each vial and syringe must be used for a single eye only. For treatment of the other eye, a new vial, syringe, and sterile equipment are required.

Patients should be monitored for intraocular pressure (IOP) elevation before and after the injection; ocular hypotensive medication may be needed if IOP rises.

• Patients with ocular or periocular infections
• Patients with active intraocular inflammation

• Endophthalmitis and Retinal Detachments: Intravitreal injections carry risks of serious eye infections or retinal detachment. Proper sterile techniques must be used to minimize these risks. Patients should report symptoms like eye pain, redness, light sensitivity, or vision changes immediately.
• Neovascular AMD: Treatment with Izervay has been associated with increased rates of wet AMD or choroidal neovascularization compared to sham treatments. Patients should be monitored for this complication.
• Increased Intraocular Pressure (IOP): Transient increases in IOP can occur after injection; monitoring is necessary to manage this if it occurs.

Common ocular side effects reported with Izervay include:

• Conjunctival hemorrhage (eye bleeding) observed in 13–17% of patients
• Increased intraocular pressure in 9–13%
• Blurred vision in 8–14%
• Choroidal neovascularization (new abnormal blood vessels) in 7–12%
• Eye pain in 4–7%
• Vitreous floaters in 2–4%
• Blepharitis (eyelid inflammation) in 2–3%
• Punctate keratitis (corneal surface inflammation) in about 10%
• Retinal hemorrhage in 4%
• Ocular hypertension in 4%
• Corneal abrasion in 2%

Less common but serious adverse events include endophthalmitis, retinal detachment, optic ischemic neuropathy, vitreous hemorrhage, vitritis, and photopsia, each reported in less than 1% of treated patients.

Store Izervay refrigerated at 2ºC to 8ºC (36ºF to 46ºF). Do not freeze or shake the vial. Prior to administration, allow the vial to reach room temperature (20ºC to 25ºC / 68ºF to 77ºF). The vial can be kept at room temperature for up to 24 hours in its original carton protected from light.