Izervay

— THERAPEUTIC CATEGORIES —
  • Miscellaneous ocular agents

Izervay Generic Name & Formulations

General Description

Avacincaptad pegol 20mg/mL; soln for intravitreal inj; preservative-free.

Pharmacological Class

Complement inhibitor.

How Supplied

Single-dose vial—1

Storage

Store IZERVAY in the refrigerator between 2°C to 8°C (36°F to 46°F). Do not freeze. Do not shake. Keep the vial in the original carton to protect from light.
Prior to use, the unopened glass vial of IZERVAY may be kept at room temperature, 20°C to 25°C (68°F to 77°F), for up to 24 hours. Ensure that the injection is given immediately after preparation of the dose.

Manufacturer

Generic Availability

NO

Mechanism of Action

Avacincaptad pegol is an RNA aptamer, a PEGylated oligonucleotide that binds to and inhibits complement protein C5. By inhibiting C5, avacincaptad pegol may prevent its cleavage to C5a and C5b thus decreasing membrane attack complex (MAC) formation.

Izervay Indications

Indications

Treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD).

Izervay Dosage and Administration

Adult

See full labeling. Each vial is for use in a single eye. Give by intravitreal inj to each affected eye. 2mg (0.1mL of 20mg/mL solution) once every monthly (approx. every 28 ± 7 days) for up to 12 months. 

Children

Not established.

Izervay Contraindications

Contraindications

Ocular or periocular infection. Active intraocular inflammation.

Izervay Boxed Warnings

Not Applicable

Izervay Warnings/Precautions

Warnings/Precautions

Must be administered by a qualified physician. Monitor for elevated IOP using tonometry prior to initiation and following inj (may give ocular hypotensive meds if needed). Monitor for endophthalmitis, retinal detachments, neovascular AMD, and perfusion of the optic nerve head following inj. Pregnancy. Nursing mothers.

Izervay Pharmacokinetics

Absorption

After a single dose, maximum plasma concentrations (Cmax) are estimated to occur approximately 7 days post-dose and mean (CV%) free avacincaptad pegol plasma Cmax is estimated to be 68.4 ng/mL (57.8%).

Metabolism

Metabolism of avacincaptad pegol has not been fully characterized. Avacincaptad pegol is expected to be catabolized by endonucleases and exonucleases to oligonucleotides of shorter lengths which may be excreted renally, in similar manner to the elimination of endogenous RNA.

Elimination

Elimination of avacincaptad pegol has not been fully characterized. The estimated apparent systemic half-life is approximately 12 days.

Izervay Interactions

Not Applicable

Izervay Adverse Reactions

Adverse Reactions

Conjunctival hemorrhage, increased IOP, blurred vision, neovascular age-related macular degeneration; endophthalmitis, retinal detachments.

Izervay Clinical Trials

Clinical Trials

The approval was based on data from the randomized, double-masked, sham-controlled, multicenter phase 3 GATHER1 (ClinicalTrials.gov Identifier: NCT02686658) and GATHER2 (ClinicalTrials.gov Identifier: NCT04435366) trials, which evaluated the efficacy and safety of Izervay in patients 50 years of age and older (mean age, 77 years) with GA secondary to AMD. Patients were randomly assigned to receive either avacincaptad pegol via intravitreal injection once monthly or sham.

The primary endpoint for both trials was the mean rate of change in GA, as measured by fundus autofluorescence at baseline, month 6, and month 12. Results from both studies showed that treatment with avacincaptad pegol led to a statistically significant reduction in the rate of GA growth from baseline to month 12 compared with sham (0.10mm/year; <.01 in GATHER1 and 0.05mm/year; <.01 in GATHER 2 with square root transformed data). The treatment was found to slow disease progression as early as 6 months. The effects were consistent across all prespecified subgroups (eg, age, gender, baseline GA disc area).

Izervay Note

Not Applicable

Izervay Patient Counseling

Cost Savings Program

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