Hi, I'm Sunir Garg, chief of the Retina Service at Wills Eye Hospital. And at the AAO subday, just presented an update on complement inhibition. The pathogenesis of AMD is really complex and we've tried a lot of different drugs, most of which didn't work, but two complement inhibitors did, and that's pegcetacoplan and avacincaptad pegol. They were approved in 2023.

And now we have up to five years data using these drugs, and there's a few things that stand out to me. Number one, the drugs help slow progression of a relentlessly progressive disease. Number two, at two-year mark, both drugs slow disease progression, somewhere around 15 to 20%.

But what's interesting is if you look at those patients out to five years, we start to see more benefit to treatment. So there's more spread between the sham or projected sham groups with the treatment groups.

The other thing that's very interesting is if you look at patients, at least in the pegcetacoplan trials, who received treatment for five years, so two years in the study and then three years as part of the open label extension, at the end of the five years, they saved on average about 3.9 millimeters squared more tissue than people who were in sham or projected sham.

But if you look at patients who for the first two years of the study were randomized to sham, then went on to treatment for an additional three years, they saved tissue, but they only saved half as much, about 1.9 millimeters squared. And we've seen that data now with both drugs.

So to me, that matters a lot because if we're not getting on top of the disease early, we can never get that tissue back. There's a lot of innovation in this space and I look forward to newer, better treatments that'll help patients stop their disease. I also look forward to endpoints that'll resonate better with the retina community.

But it's a really exciting time for us, both as a specialty as well as these physicians who take care of patients with GA.