Eylea keeps its lead in the retinal space as physicians remain hesitant on Roche's Susvimo — report
Roche trumpeted a “major advancement” in the retinal space with the approval of its eye drug Susvimo last October, touting it as a more manageable option for patients with wet age-related macular degeneration. However, safety concerns leave some physicians hesitant.
While most ophthalmologists have heard of Susvimo — 86%, according to the latest Spherix survey of 76 doctors — only one in ten believe the benefits completely outweigh the risks. And a majority of the respondents said they’d turn to Regeneron’s Eylea as a safer and more accessible option.
Susvimo snagged an FDA win back in October, just a month after regulators cleared the first biosimilar to Roche’s blockbuster Lucentis. Unlike Lucentis’ monthly injections — or Eylea’s 8- to 12-week injections — the Susvimo implant is inserted in the eye during a one-time outpatient procedure, and only needs to be refilled every six months.
“With Susvimo, my patients now have an option that can help them maintain their vision as well as anti-VEGF injections, but on a more manageable twice-yearly treatment schedule,” said Carl Regillo, an investigator on the Phase III Susvimo study.
Ophthalmologists acknowledged this benefit, with a third of them calling the drug a “substantial advance to the market.” And two-fifths of doctors who prescribed Susvimo cited a decreased treatment burden as their main reason. But Roche still has a lot of work to do before it catches up to Eylea — if it ever does.
Eylea has dominated the diabetic macular edema and wet age-related macular degeneration markets for nearly a decade — and physicians suspect it will continue to beat out Lucentis, Susvimo and Roche’s other eye contender Vabysmo over the next six months. Only two of five physicians said they plan on prescribing Susvimo for the first time in the next six months, while another quarter of physicians said they expect to wait seven months to a year.
Of those hesitant to prescribe Susvimo, most cited safety and tolerability concerns, followed by reimbursement uncertainty.
In the Phase III Archway trial, Susvimo was associated with a three-fold higher rate of endophthalmitis, or severe inflammation of the tissues inside the eye, compared to patients receiving monthly Lucentis injections. The most common side effects were conjunctival hemorrhage, conjunctival hyperemia, iritis and eye pain, Roche reported last year.
Roche read out long-term data for Susvimo back in February, reporting that 95% of patients were able to maintain a six-month treatment schedule. At two years, the most common side effects of “special interest” were cataract, conjunctival bleb and vitreous haemorrhage, Roche said.
Susvimo raked in just under $1 million (CHF 1 million) last quarter, according to Roche. Meanwhile, Eylea saw $1.5 billion in sales, a 13% boost over the first quarter of last year.
Don’t count Susvimo out just yet. Almost half of the patients who switched to Susvimo were previously treated with Eylea, according to Spherix. And of the doctors who prescribed it, none reported dissatisfaction. Nearly two-fifths reported “extreme satisfaction,” while the rest said they were moderately satisfied.
Correction: Eylea’s dosing schedule is 8-12 weeks, not months.