avacincaptad pegol intravitreal

Action and Spectrum

Actions and Spectrum: 

avacincaptad pegol is a complement factor C5 inhibitor for treating geographic atrophy secondary to age-related macular degeneration (AMD).

Its action involves targeting the complement cascade, specifically the C5 protein, which plays a role in the immune response and inflammation.

By inhibiting C5, avacincaptad pegol aims to reduce the downstream effects of complement activation, such as tissue damage and inflammation in the retina. 

Drug Interaction

Adverse Reaction

Pending

Black Box Warning

Black Box Warning: 

None 

Contraindication / Caution

Contraindication/Caution: 

Contraindication 

None 

Caution 

• Infection Risk: Intravitreal injections can potentially introduce infections into the eye. Special precautions should be taken to maintain sterile conditions during the procedure. 
• Endophthalmitis: There is a risk of developing endophthalmitis, a severe inner eye infection. Prompt medical attention is necessary if symptoms such as eye pain, redness, swelling, or vision changes occur after the injection. 
• Retinal Detachment: There have been reports of retinal detachment following intravitreal injections. Patients should be monitored for any signs or the symptoms of retinal detachment, such as sudden or increased floaters, flashes of light, or decreased vision. 
• Elevated Intraocular Pressure: Intravitreal injections can sometimes lead to increased pressure inside the eye. Patients should be monitored for changes in intraocular pressure and managed appropriately. 
• Allergic Reactions: Although uncommon, allergic reactions to intravitreal injections are possible. Patients should inform their healthcare provider of known allergies or previous adverse reactions to medications. 
• Systemic Effects: Although avacincaptad pegol is administered directly into the eye, there is still a potential for systemic absorption and effects.

Pregnancy / Lactation

Pregnancy consideration:  

US FDA pregnancy category: Not assigned. 

Lactation:   

Excreted into human milk: Not known. 

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    
• Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

avacincaptad pegol is an intravitreal pharmacological agent that demonstrates its potential in the field of ophthalmology. It acts as an inhibitor of the complement factor C5, which plays a crucial role in the inflammatory response and complement-mediated tissue damage in various ocular diseases, particularly neovascular age-related macular degeneration (nAMD).

avacincaptad pegol binds to C5 with high affinity, preventing its cleavage into C5a and C5b, thereby inhibiting the formation of the MAC (membrane attack complex) and subsequent complement-mediated inflammation. By interfering with the complement cascade, avacincaptad pegol offers a promising approach to treating nAMD, potentially reducing disease progression and preserving visual acuity. 

Pharmacodynamics: 

Mechanism of action: It involves targeting the complement system, specifically the C5 protein, to inhibit complement activation and reduce inflammation and tissue damage in the retina. 

The complement system is a part of the immune system that plays a role in defense against infections and tissue homeostasis. However, in certain conditions, such as AMD, the complement system can become dysregulated and contribute to inflammation and damage in the retina, including the development and progression of GA. 

avacincaptad pegol is designed as a complement factor C5 inhibitor. It binds to the C5 protein, preventing its cleavage into C5a and C5b, key complement cascade components. By inhibiting C5, avacincaptad pegol interrupts downstream complement activation, reducing the formation of the membrane attack complex (MAC) and the release of pro-inflammatory mediators. 

avacincaptad pegol aims to slow down the progression of GA and preserve visual function in patients with AMD by inhibiting complement activation and subsequent inflammation. Its targeted action on the complement system is intended to mitigate the tissue damage and inflammatory response that contribute to the development and expansion of GA lesions. 

Pharmacokinetics: 

Absorption 

Intravitreal injections deliver the medication directly into the eye’s vitreous humor, bypassing absorption processes in the gastrointestinal tract. The medication is introduced into the target tissue, allowing for localized action. 

Distribution 

The distribution of intravitreally injected medications is primarily limited to the eye. The medication spreads within the vitreous humor and may diffuse to adjacent ocular structures. 

Metabolism 

Metabolic processes specific to avacincaptad pegol following intravitreal administration have not been extensively characterized. It is important to note that intravitreal medications often undergo minimal systemic metabolism due to their limited systemic exposure. 

Elimination and Excretion 

The excretion route of avacincaptad pegol following intravitreal administration needs to be well-documented. The medication may be eliminated from the eye through various mechanisms, including clearance via the anterior chamber angle or diffusion into the systemic circulation. 

Adminstartion

Administration: 

avacincaptad pegol is administered as an intravitreal injection, which is injected directly into the eye’s vitreous humor.  

• Preparation: The healthcare professional will prepare the equipment and the avacincaptad pegol injection according to the manufacturer’s instructions. This includes ensuring proper aseptic technique and maintaining sterile conditions. 
• Anesthesia: The eye may be numbed using a local anesthetic before the injection. This can be through eye drops, gel, or injections. 
• Cleaning and Sterilization: The area around the eye, including the eyelids and surrounding skin, will be cleaned and sterilized to diminish the risk of infection. 
• Injection: The healthcare professional will use a specialized syringe and needle to deliver the avacincaptad pegol into the vitreous humor, the gel-like substance in the back portion of the eye. 
• Post-Injection Care: After the injection, the eye may be monitored briefly to check for any immediate complications or adverse reactions. The healthcare professional may provide post-injection instructions, which may include the use of eye drops or other medications. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: avacincaptad pegol intravitreal 

Why do we use avacincaptad pegol intravitreal? 

avacincaptad pegol (Zimura) is for its used in the treatment of GA (geographic atrophy) secondary to AMD (age-related macular degeneration). Geographic atrophy is a progressive and advanced form of AMD that leads to the loss of retinal pigment epithelial cells and photoreceptors, resulting in central vision loss.