Objective:

To analyze factors associated with treatment discontinuation in patients receiving complement inhibitors for geographic atrophy (GA), emphasizing the significance of understanding these factors.

Key Findings:

• Discontinuation rates of GA therapy increased over time, regardless of the treatment agent used, defined as a treatment gap exceeding 120 days.
• 31.6% of study eyes had coexisting neovascular AMD.
• Mean visual acuity across the cohort was 55 ETDRS letters.
• Significant attrition was noted over 18 months in patients receiving intravitreal treatments for GA.

Interpretation:

The study highlights the challenges in maintaining long-term adherence to GA therapies, with various baseline factors influencing discontinuation, which may have significant implications for treatment strategies.

Limitations:

• Differences in FDA approval dates complicate direct comparisons between treatment groups, potentially affecting the validity of the findings.
• Few patients receiving avacincaptad pegol reached the 18-month interval, limiting long-term persistence conclusions.
• Further longitudinal analysis is needed to clarify reasons for treatment discontinuation.

Conclusion:

Further follow-up is required to understand the trends in treatment discontinuation and the underlying causes, particularly focusing on factors such as disease progression and treatment fatigue.