FDA

Izervay

Approved 4 Aug 2023IntravitrealSolution

Indications

IZERVAY ® is indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). IZERVAY is a complement inhibitor indicated for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD) ( 1 ).

Contraindications

Ocular or periocular infections ( 4.1 ).
Active intraocular inflammation ( 4.2 ).

4.1Ocular or Periocular Infections

IZERVAY is contraindicated in patients with ocular or periocular infections.

4.2Active Intraocular Inflammation

IZERVAY is contraindicated in patients with active intraocular inflammation.

Warnings and precautions

Endophthalmitis and Retinal Detachments ( 5.1 ).
Neovascular AMD ( 5.2 )
Increase in Intraocular Pressure (IOP) ( 5.3 ).

5.1Endophthalmitis and Retinal Detachments

Intravitreal injections may be associated with endophthalmitis and retinal detachments [see Adverse Reactions (6.1) ] . Proper aseptic injection techniques must always be used when administering IZERVAY in order to minimize the risk of endophthalmitis [see Dosage and Administration (2.4) ] . Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay, to permit prompt and appropriate management [see Patient Counseling Information (17) ] .

5.2 Neovascular AMD In the GATHER1 and GATHER2 clinical trials, use of IZERVAY was associated with increased rates of neovascular (wet) AMD or choroidal neovascularization (7% when administered monthly and 4% in the sham group) by Month 12. Over 24 months, the rate of neovascular (wet) AMD or choroidal neovascularization in the GATHER2 trial was 12% in the IZERVAY group and 9% in the sham group. Patients receiving IZERVAY should be monitored for signs of neovascular AMD.

At a glance

Brand name: Izervay
Active substance: avacincaptad pegol sodium
Route: Intravitreal
Dosage form: Solution
Applicant: Astellas
Status: Prescription
FDA approval: 4 Aug 2023
Application: NDA217225-001

Contraindications

Ocular or periocular infections ( 4.1 ).
Active intraocular inflammation ( 4.2 ).

4.1Ocular or Periocular Infections

IZERVAY is contraindicated in patients with ocular or periocular infections.

4.2Active Intraocular Inflammation

IZERVAY is contraindicated in patients with active intraocular inflammation.

Warnings and precautions

Endophthalmitis and Retinal Detachments ( 5.1 ).
Neovascular AMD ( 5.2 )
Increase in Intraocular Pressure (IOP) ( 5.3 ).

5.1Endophthalmitis and Retinal Detachments

Adverse reactions

The following potentially serious adverse reactions are described elsewhere in the labeling:

Ocular and periocular infections [see Contraindications (4.1) ]
Active intraocular inflammation [see Contraindications (4.2) ]
Endophthalmitis and retinal detachments [see Warnings and Precautions (5.1) ]
Neovascular AMD [see Warnings and Precautions (5.2) ]
Increase in intraocular pressure [see Warnings and Precautions (5.3) ] The most common adverse reactions (incidence ≥ 5%) were conjunctival hemorrhage, increased IOP, blurred vision, neovascular age-related macular degeneration, punctate keratitis, and eye pain ( 6.1 ). To report SUSPECTED ADVERSE REACTIONS, contact Astellas Pharma US, Inc. at 1-800-727-7003 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .

6.1Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety of avacincaptad pegol was evaluated in 733 patients with AMD in two sham-controlled studies (GATHER1 and GATHER2). Of these patients, 292 were treated with intravitreal IZERVAY 2 mg (0.1 mL of 20 mg/mL solution) [see Clinical Studies (14) ] .

Three hundred thirty-two (332) patients were assigned to sham. Adverse reactions reported in ≥2% of patients who received treatment with IZERVAY for up to 12 months pooled across the GATHER1 and GATHER2 studies are listed below in Table 1 . Table 1: Common Ocular Adverse Reactions (≥2%) and greater than Sham in Study Eye up to 12 months 1 Blurred vision includes visual impairment, vision blurred, visual acuity reduced, visual acuity reduced transiently.

Adverse Drug Reactions IZERVAY N=292 Sham N=332 Conjunctival hemorrhage 13% 9% Increased IOP 9% 1% Blurred vision 1 8% 5% Choroidal neovascularization 7% 4% Eye pain 4% 3% Vitreous floaters 2% <1% Blepharitis 2% <1% Adverse reactions reported in ≥ 2% of patients who received treatment with IZERVAY for up to 24 months in the GATHER2 study are listed below in Table 2 . Table 2: Common Ocular Adverse Reactions (≥ 2%) and greater than Sham in Study Eye up to 24 months 1 Blurred vision includes visual impairment, vision blurred, visual acuity reduces, visual acuity reduced transiently and blindness transient. 2 Punctate keratitis includes punctate keratitis and keratitis.

Adverse Drug Reactions IZERVAY (N=225) Sham (N=222) Conjunctival hemorrhage 17% 9% Blurred vision 1 14% 5% Increased IOP 13% 1% Choroidal neovascularization 12% 9% Punctate keratitis 2 10% 8% Eye pain 7% 4% Retinal hemorrhage 4% 3% Vitreous floaters 4% <1% Ocular hypertension 4% 0 Blepharitis 3% <1% Corneal abrasion 2% <1% Photopsia, optic ischemic neuropathy, vitreous hemorrhage, vitreal cells, vitritis, and endophthalmitis were each reported in ≤ 1% of patients treated with IZERVAY for up to 24 months across the GATHER1 and GATHER2 studies.

Izervay

Indications

Contraindications

4.1Ocular or Periocular Infections

4.2Active Intraocular Inflammation

Warnings and precautions

5.1Endophthalmitis and Retinal Detachments

At a glance

Two medicines in one question?

Izervay

Indications

Contraindications

4.1Ocular or Periocular Infections

4.2Active Intraocular Inflammation

Warnings and precautions

5.1Endophthalmitis and Retinal Detachments

At a glance

Two medicines in one question?

Pregnancy and breastfeeding

8.1Pregnancy Risk Summary

Adverse reactions

6.1Clinical Trials Experience

Composition

Official product information