Treatments · Wet AMD · Sustained-Release Anti-VEGF Implant · Updated May 2026
Private Axpaxli (axitinib) sustained-release wet AMD implant, UK 2026
Axpaxli (also known as EYP-1901, EyePoint Pharmaceuticals) is a bioerodible intravitreal insert pre-loaded with axitinib, a small-molecule pan-VEGF receptor tyrosine kinase inhibitor (TKI). Placed in the eye in a brief in-clinic intravitreal procedure, the implant slowly releases axitinib for many months, with the aim of reducing the heavy injection burden of monthly or two-monthly anti-VEGF therapy for neovascular (wet) age-related macular degeneration. In 2026, Axpaxli is investigational: the Phase 3 LUGANO and LUCIA randomised trials are recruiting in the UK and internationally, with readouts expected late 2026 to 2027. UK access this year is therefore principally via clinical trial enrolment at participating retinal centres rather than routine private prescription.
- What it is: bioerodible Durasert E intravitreal insert of axitinib (a pan-VEGF TKI).
- Indication being studied: previously treated and treatment-naive neovascular wet AMD.
- Target interval: 6-12 months between procedures (vs monthly/bi-monthly injections today).
- Status (May 2026): Phase 3 LUGANO & LUCIA underway; not yet FDA/EMA approved.
- UK route in 2026: clinical trial enrolment or named-patient access at participating centres.
Consultant retinal review and trial eligibility check: 0800 852 7782. Same-week appointments at CQC-registered UK retinal clinics.
Fast answer: what is Axpaxli and how do I get it in the UK?
Axpaxli (axitinib, EYP-1901) is an investigational bioerodible intravitreal insert designed to deliver the pan-VEGF tyrosine kinase inhibitor axitinib continuously inside the eye for six to twelve months from a single in-clinic procedure. The clinical goal is straightforward: cut the heavy monthly or bi-monthly injection burden of current wet AMD treatment to one or two procedures a year while maintaining the same visual gains. In 2026 the device is in Phase 3 trials (LUGANO and LUCIA) and is not yet routinely approved by the FDA or EMA. UK access in 2026 is principally via clinical trial enrolment at participating retinal centres; routine private prescription will follow regulatory approval.
Drug delivered
Axitinib, a small-molecule pan-VEGF receptor TKI.
Target interval
6-12 months between procedures.
Status (May 2026)
Phase 3 LUGANO & LUCIA underway; not yet approved.
UK access in 2026
Trial enrolment or named-patient programme.
Honest one-liner: Axpaxli is the most promising long-acting wet AMD pipeline asset of 2026, but routine private use will not begin in the UK until Phase 3 data and EMA/MHRA approval — today the realistic route is a trial place.
What is Axpaxli (axitinib intravitreal insert)?
Axpaxli (formerly known as EYP-1901) is an intravitreal sustained-release insert developed by EyePoint Pharmaceuticals. The active drug is axitinib, a small-molecule pan-VEGF receptor tyrosine kinase inhibitor (TKI) already used systemically in oncology. The carrier is EyePoint's Durasert E platform, a bioerodible polymer rod that slowly releases axitinib into the vitreous over many months before fully degrading, leaving no permanent material in the eye. The insert is placed into the vitreous cavity via a tiny in-clinic injection using a fine needle and applicator, in the same way as a conventional intravitreal anti-VEGF injection.
The clinical rationale is to address the central limitation of current wet AMD therapy: although ranibizumab, aflibercept, aflibercept 8 mg and faricimab give excellent visual outcomes, they require ongoing injections every one to four months, sometimes for many years. That injection burden drives under-treatment, anxiety, time-cost and progressive vision loss when intervals slip. A sustained-release implant that maintains anti-VEGF effect for 6 to 12 months from a single procedure could transform real-world wet AMD outcomes by simplifying the schedule and improving adherence.
As of May 2026, Axpaxli is investigational. The Phase 3 LUGANO and LUCIA randomised pivotal trials are recruiting and treating patients across the UK, Europe, North America and Asia, with primary efficacy readouts expected late 2026 to 2027. UK eligible patients can be referred into trial enrolment via participating retinal centres. The page below summarises the device, evidence to date, candidacy and pathway. For the broader wet AMD treatment menu, see the wet AMD treatments page, the parent wet AMD condition page and private anti-VEGF injections page.
UK 2026 access pathways and expected private cost
Because Axpaxli is investigational in 2026, there is no list price for routine private use. The table below shows the realistic 2026 access pathways and a working estimate of expected private self-pay cost once Axpaxli is approved, modelled on existing premium retinal pharma such as aflibercept 8 mg (Eylea HD) and faricimab (Vabysmo). All numbers in the future-pricing rows are estimates and not contractual.
For published current-generation private wet AMD pricing, see our aflibercept 8 mg (Eylea HD) cost page and faricimab (Vabysmo) cost page. For dry AMD and geographic atrophy comparators see Syfovre and Izervay.
What is included in an Axpaxli pathway?
Consultant medical retina assessment
Best-corrected acuity, slit-lamp examination, dilated fundus examination, macular OCT and OCT-A, fundus autofluorescence and where indicated fluorescein or indocyanine green angiography.
Disease characterisation
Wet AMD subtype, lesion size, fluid pattern and treatment history are mapped against current Axpaxli trial eligibility criteria.
Trial referral or named-patient routing
Eligible patients are routed into LUGANO or LUCIA where slots are open, or into a named-patient or future post-approval pathway.
Implant procedure
Topical anaesthesia, povidone-iodine prep, intravitreal placement of the Axpaxli insert via a small applicator at the pars plana; a few-minute in-clinic procedure.
Structured follow-up
Day-1 or week-1 check, monthly OCT and visual acuity reviews, with supplemental anti-VEGF injection only if disease activity reappears.
Re-implantation planning
As the bioerodible Axpaxli implant nears full release, the consultant plans the next procedure or pivots to an alternative agent depending on response.
What does the evidence say about Axpaxli?
The Phase 1 DAVIO trial (reported 2023) established safety and dose-finding in patients with previously treated wet AMD, with no drug-related serious ocular adverse events at the doses studied. Patients tolerated the implant well and showed encouraging signals of reduced supplemental anti-VEGF need over six months.
The Phase 2 DAVIO 2 randomised trial (reported 2024, presented at the Angiogenesis, Exudation and Degeneration Symposium and the American Academy of Ophthalmology) compared two doses of Axpaxli with on-label aflibercept dosing in previously treated wet AMD. Across approximately 160 randomised eyes, both Axpaxli doses maintained visual acuity comparable with aflibercept while approximately three quarters of treated eyes required no supplemental anti-VEGF injection in the six months following placement; OCT central subfield thickness remained stable. The implant was generally well tolerated, with the principal adverse events being transient post-procedure intraocular pressure changes and mild inflammation.
On the back of those results, EyePoint launched the global Phase 3 LUGANO and LUCIA randomised pivotal trials in 2024-2025. LUGANO is studying Axpaxli versus on-label aflibercept in treatment-naive wet AMD; LUCIA is studying Axpaxli versus on-label aflibercept in previously treated wet AMD. Both trials are recruiting at UK retinal centres in 2026, with primary outcome readouts expected late 2026 to 2027. For the broader treatment landscape see our wet AMD vs dry AMD news article.
Axpaxli vs current wet AMD treatments
For deeper pricing context on current generation anti-VEGF agents, see our aflibercept 8 mg (Eylea HD) cost page, faricimab cost page and private anti-VEGF wet AMD injections page. The same anti-VEGF class is also used in retinal vein occlusion treatment.
Are you a candidate for Axpaxli (LUGANO/LUCIA)?
Likely eligible
- Adults with confirmed neovascular wet AMD on OCT and angiography.
- Recent demonstrated response to current anti-VEGF therapy (LUCIA) or treatment-naive (LUGANO).
- Visual acuity within trial range and intact fovea.
- No active uveitis, endophthalmitis or other significant intraocular inflammation.
- Willing and able to attend protocol-specified visits.
Likely not eligible
- Geographic atrophy without active neovascular disease (see dry AMD instead).
- Significant fibrotic scar covering the fovea.
- Coexisting active retinal vascular disease that confounds outcome.
- Recent intraocular surgery or laser within the trial wash-out period.
- Unable to commit to trial visit schedule or imaging requirements.
Eligibility is decided after a structured medical retina consultation that includes OCT, OCT-A and angiography. Many patients start with a free initial online review before an in-person workup.
NHS vs private Axpaxli in the UK
In 2026 there is no routine NHS Axpaxli pathway because the device is not yet approved. Selected NHS tertiary retinal centres are recruiting investigators or sites for LUGANO and LUCIA, and NHS patients can in principle be referred into trial enrolment via their consultant. Outside of trials, NHS treatment for wet AMD continues to be standard intravitreal anti-VEGF therapy with ranibizumab, aflibercept, aflibercept 8 mg or faricimab, delivered through high-volume macular clinics.
The private route offers two practical advantages in 2026: rapid consultant retinal assessment and signposting to participating Axpaxli trial sites, and immediate access to current premium anti-VEGF agents (aflibercept 8 mg, faricimab) as bridge therapy while waiting for a trial slot or for regulatory approval. Once Axpaxli is approved, a private pathway is expected to give earlier access than national NHS commissioning, in the same pattern as faricimab and aflibercept 8 mg in 2023-2025.
Insurance and funding
Because Axpaxli is investigational in 2026, UK private medical insurers do not currently cover it as a routine procedure. Patients enrolled in LUGANO or LUCIA receive trial-funded treatment at no cost for the device and protocol-specified procedures. Private insurers (Bupa, AXA, Aviva, Vitality and others) will cover the underlying consultant retinal assessment, OCT and current-generation anti-VEGF injections used as bridge therapy under existing wet AMD policies, subject to pre-authorisation. Post-approval, Axpaxli is expected to be reviewed by insurers on a case-by-case basis under existing wet AMD chronic-disease pathways.
For self-pay patients, fixed quotes and finance plans for bridge anti-VEGF therapy are available; see our finance page and insured patients page.
Risks and limitations of Axpaxli
- Intravitreal procedure risks: small risk (approximately 1 in 2,000-5,000) of endophthalmitis, vitreous haemorrhage or retinal tear common to any intravitreal procedure.
- Transient inflammation: mild post-procedural anterior chamber or vitreous reaction usually settles with topical steroid drops.
- IOP changes: brief intraocular pressure rises are reported and managed with monitoring.
- Implant migration: rare; the bioerodible rod is designed to sit posteriorly and degrade in situ.
- Disease breakthrough: in a minority of eyes, anti-VEGF effect attenuates before the implant fully degrades and supplemental injection is required.
- Investigational status: long-term safety and durability data are still maturing; trial participation includes structured follow-up imaging.
- No guarantee of approval: Phase 3 trials remain dependent on regulatory outcomes; product availability after readout cannot be guaranteed.
Your trial team or consultant retinal specialist will go through these and any individual factors at consent, and you will be given a written, named contact route for urgent concerns.
Recovery and visit schedule after Axpaxli
First 24-48 hours
Mild gritty sensation; possible small floater. Lubricant drops; resume normal light activity the next day.
Week 1
Day-1 or week-1 IOP and slit-lamp check; resume driving and screens.
Month 1-6
Monthly OCT and visual acuity; supplemental anti-VEGF only if recurrence; structured trial visits.
Month 6-12
Implant nears full release; consultant plans re-implantation or pivots to alternative agent.
How to choose a UK Axpaxli pathway clinic
- Consultant medical retina expertise: the consultant should have a high-volume wet AMD practice and trial experience.
- LUGANO or LUCIA site or referral pathway: ask whether the clinic is an active site or refers efficiently into participating UK trial centres.
- Modern imaging capability: in-house OCT, OCT-A and fundus autofluorescence with same-visit reporting.
- Full anti-VEGF menu: the clinic should also offer current premium agents as bridge therapy where appropriate.
- CQC registration: intravitreal procedures should be performed in a CQC-registered ophthalmic environment with full sterile technique.
- Transparent communication: written explanation of trial vs commercial pathway, expected costs and a named urgent contact route.
For an independent assessment of whether an Axpaxli pathway is right for your wet AMD, request a free initial online consultation or make an in-person appointment.
Axpaxli frequently asked questions
Is Axpaxli approved in the UK in 2026?
No. As of May 2026, Axpaxli (axitinib intravitreal insert, EYP-1901) is investigational. The Phase 3 LUGANO and LUCIA randomised pivotal trials are recruiting at UK retinal centres, with primary efficacy readouts expected late 2026 to 2027. EMA and MHRA approval and a commercial UK launch will depend on those Phase 3 results.
How does Axpaxli work?
Axpaxli is a bioerodible polymer rod pre-loaded with axitinib, a small-molecule pan-VEGF receptor tyrosine kinase inhibitor. After a brief in-clinic intravitreal injection, the rod sits in the vitreous and slowly releases axitinib for many months, blocking abnormal blood vessel growth and leakage in neovascular wet AMD. As the polymer fully erodes, no permanent material is left in the eye.
How long does an Axpaxli implant last?
The Phase 2 DAVIO 2 trial showed approximately three quarters of treated eyes needed no supplemental anti-VEGF injection for six months after a single Axpaxli implant. The Phase 3 LUGANO and LUCIA trials are testing target intervals of six to twelve months. Real-world durability in individual patients will depend on baseline disease activity and lesion type.
Can I get Axpaxli privately in the UK now?
Not as a routine commercial procedure. UK access in 2026 is via Phase 3 LUGANO or LUCIA trial enrolment at participating retinal centres, or a small number of named-patient or expanded-access slots where available. Routine private prescription is expected to follow regulatory approval.
How much will Axpaxli cost privately once approved?
Pricing is not yet set. A reasonable working estimate for UK 2026-2027 private self-pay, modelled on current premium retinal pharma such as aflibercept 8 mg and faricimab, is in the region of GBP 3,500-6,500 per implant before consultant fees and follow-up imaging; this is an estimate only and not contractual.
How does Axpaxli compare with faricimab or aflibercept 8 mg?
Faricimab and aflibercept 8 mg are approved injection-based anti-VEGF agents and extend treatment intervals to as much as 16 weeks in many patients but still require ongoing injections every two to four months. Axpaxli is a sustained-release implant aiming for six to twelve months between procedures from a single placement; it is investigational and not yet approved.
Does Axpaxli mean no more injections?
It is designed to dramatically reduce them. In DAVIO 2 about three quarters of treated eyes needed no supplemental anti-VEGF injection for six months. Some eyes still require an occasional rescue injection as the implant nears the end of its release window, and a planned re-implantation is expected once the polymer is fully eroded.
Is Axpaxli being studied for diabetic eye disease?
Yes. EyePoint is running parallel trials of Axpaxli in diabetic retinopathy and diabetic macular oedema in addition to the wet AMD LUGANO and LUCIA programmes, although wet AMD is the lead indication.
Does Axpaxli help dry AMD or geographic atrophy?
No, Axpaxli targets the abnormal blood vessels of neovascular wet AMD via VEGF receptor inhibition. Dry AMD and geographic atrophy are driven by different mechanisms and are treated, where indicated, with complement-pathway agents such as Syfovre or Izervay. See our dry AMD condition page.
Does the procedure hurt?
Implant placement uses topical anaesthetic drops and most patients feel pressure rather than pain. There is a mild gritty sensation for a day or two afterwards that settles with lubricants.
Can I drive after the procedure?
Driving is usually advised against on the day of the procedure; most patients are back to normal driving within 24-48 hours, provided the consultant confirms the eye looks settled.
Will my private medical insurance pay for Axpaxli?
Not for the investigational drug in 2026; the underlying consultant retinal assessment, OCT and bridge anti-VEGF injections are usually covered under standard wet AMD policies subject to pre-authorisation. Post-approval, insurers will review Axpaxli on a case-by-case basis under existing wet AMD chronic-disease pathways.
Where can I be referred for an Axpaxli trial slot?
Eligible patients are referred from a private consultant medical retina assessment into LUGANO or LUCIA at participating UK retinal centres, or onto a named-patient or future post-approval pathway where applicable. Book an initial assessment to start the process.
Methodology and sources
Content on this page reflects the publicly available Phase 1 DAVIO and Phase 2 DAVIO 2 clinical trial reports for Axpaxli (EYP-1901), the public LUGANO and LUCIA Phase 3 trial registrations on ClinicalTrials.gov, presentations at the AAO and Angiogenesis, Exudation and Degeneration Symposium between 2023 and 2026, and EyePoint Pharmaceuticals corporate disclosures. Cost estimates for the future commercial pathway are modelled on UK 2026 private pricing for aflibercept 8 mg (Eylea HD) and faricimab (Vabysmo) and are not contractual. Clinical content has been written by the Eye Surgery Clinic editorial team, reviewed by a UK GMC-registered consultant ophthalmologist with medical retina subspecialty interest. Page last reviewed 24 May 2026 against the live URL set on eyesurgeryclinic.co.uk.
Book a consultant retinal assessment
Find out whether you are eligible for the Phase 3 LUGANO or LUCIA Axpaxli trials, or for current generation private anti-VEGF therapy as bridge treatment, with a same-week consultant appointment and full medical retina workup.
Or call 0800 852 7782.
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