Progresses in the treatment of exudative age-related macular degeneration with anti-vascular endothelial growth factor drugs_Chinese Journal of Ocular Fundus Diseases

Authors：

Du Xueli , Li Wenbo ,  Hu Bojie

Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin Medical University, Tianjin 300384, China;

Corresponding author：

Hu Bojie, Email: bhu07@tmu.edu.cn

Keywords：

Wet macular degeneration/drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal, humanized/therapeutic use; Review

DOI：

10.3760/cma.j.issn.1005-1015.2018.05.021

Video：

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Abstract Full text Figures/Tables Video References Cited by

Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) drugs, including monoclonal antibodies (such as bevacizumab and ranibizumab) and fusion protein agents (such as aflibercept and conbercept) have been proven to be effective in the treatment of wet age-related macular degeneration (wAMD). However, there are still some patients with poor efficacy, such as no response to initial treatment or poor response, and even relapse during the course of treatment. In view of the different targets and molecular characteristics of anti-VEGF drugs, the switch of anti-VEGF drugs and the adjustment of delivery pattern, dosages and intervals have been the strategies to cope with the poor efficacy in clinic. However, there are some differences in the results of current studies. Overall, the recovery of retinal anatomical outcome achieves more benefits, and it is relatively difficult to improve visual acuity. To determine which regimen would get the biggest benefits, a large number of randomized controlled clinical trials and long study period will be needed.

Citation： Du Xueli, Li Wenbo, Hu Bojie. Progresses in the treatment of exudative age-related macular degeneration with anti-vascular endothelial growth factor drugs. Chinese Journal of Ocular Fundus Diseases, 2018, 34(5): 498-503. doi: 10.3760/cma.j.issn.1005-1015.2018.05.021 Copy

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7. Jin E, Bai Y, Luo L, et al. Serum levels of vascular endothelial growth factor before and after intravitreal injection of ranibizumab or conbercept for neovascular age-related macular degeneration[J]. Retina, 2017, 37(5): 971-977. DOI: 10.1097/IAE.0000000000001274.
8. Apte RS, Modi M, Masonson H, et al. Pegaptanib 1-year systemic safety results from a safety-pharmacokinetic trial in patients with neovascular age-related macular degeneration [J]. Ophthalmology, 2007, 114(9): 1702-1712. DOI: 10.1016/j.ophtha.2007.02.021.
9. Michalewski J, Nawrocki J, Trębińska M, et al. Switch to a single dose of aflibercept in bevacizumab nonresponders with AMD[J]. Can J Ophthalmol, 2014, 49(5): 431-435. DOI: 10.1016/j.jcjo.2014.07.012.
10. Gasperini JL, Fawzi AA, Khondkaryan A, et al. Bevacizumab and ranibizumab tachyphylaxis in the treatment of choroidal neovascularisation[J]. Br J Ophthalmol, 2012, 96(1): 14-20. DOI: 10.1136/bjo.2011.204685.
11. Leveziel N, Pelat T, Watier H, et al. Detection of antiranibizumab antibodies among patients with exudative age-related macular degeneration[J]. Ophthalmologica, 2014, 232(1): 53-56. DOI: 10.1159/000360186.
12. Funk M, Karl D, Georgopoulos M, et al. Neovascular age-related macular degeneration: intraocular cytokines and growth factors and the influence of therapy with ranibizumab[J]. Ophthalmology, 2009, 116(12): 2393-2399. DOI: 10.1016/j.ophtha.2009.05.039.
13. Lazzeri S, Nardi M, Bocci G. Pharmacogenetic labyrinth of neovascular age-related macular degeneration therapy: how to escape and move forward?[J]. Pharmacogenomics, 2013, 14(11): 1239-1242. DOI: 10.2217/pgs.13.100.
14. Chang AA, Li H, Broadhead GK, et al. Intravitreal aflibercept for treatment-resistant neovascular age-related macular degeneration[J]. Ophthalmology, 2014, 121(1): 188-192. DOI: 10.1016/j.ophtha.2013.08.035.
15. Kumar N, Marsiglia M, Mrejen S, et al. Visual and anatomical outcomes of intravitreal aflibercept in eyes with persistent subfoveal fluid despite previous treatments with ranibizumab in patients with neovascular age-related macular degeneration[J]. Retina, 2013, 33(8): 1605-1612. DOI: 10.1097/IAE.0b013e31828e8551.
16. Fassnacht-Riederle H, Becker M, Graf N, et al. Effect of aflibercept in insufficient responders to prior anti-VEGF therapy in neovascular AMD[J]. Graefe’s Arch Clin Exp Ophthalmol, 2014, 252(11): 1705-1709. DOI: 10.1007/s00417-014-2589-3.
17. Singh RP, Srivastava S, Ehlers JP, et al. A single-arm, investigator-initiated study of the efficacy, safety and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration, previously treated with ranibizumab or bevacizumab: 6-month interim analysis[J]. Br J Ophthalmol, 2014, 98 Suppl 1: S22-27. DOI: 10.1136/bjophthalmol-2013-304798.
18. Heussen FM, Shao Q, Ouyang Y, et al. Clinical outcomes after switching treatment from intravitreal ranibizumab to aflibercept in neovascular age-related macular degeneration[J]. Graefe’s Arch Clin Exp Ophthalmol, 2014, 252(6): 909-915. DOI: 10.1007/s00417-013-2553-7.
19. Gillies MC, Daien V, Nguyen V, et al. Re: Comparison of Age-Related Macular Degeneration Treatments Trials (CATT) Research Group, et al.: Five-year outcomes with anti-vascular endothelial growth factor treatment of neovascular age-related macular degeneration: the comparison of age-related macular degeneration treatments trials (Ophthalmology 2016;123: 1751-1761)[J]. Ophthalmology, 2017, 124(3): 31-32. DOI: 10.1016/j.ophtha.2016.05.054.
20. Patel KH, Chow CC, Rathod R, et al. Rapid response of retinal pigment epithelial detachments to intravitreal aflibercept in neovascular age-related macular degeneration refractory to bevacizumab and ranibizumab[J]. Eye (Lond), 2013, 27(5): 663-667. DOI: 10.1038/eye.2013.31.
21. Seguin-Greenstein S, Lightman S, Tomkins-Netzer O, et al. A meta-analysis of studies evaluating visual and anatomical outcomes in patients with treatment resistant neovascular age-related macular degeneration following switching to treatment with aflibercept[J/OL]. J Ophthalmol, 2016, 2016: 4095852[2016-03-06]. http://dx.doi.org/10.1155/2016/4095852.DOI:10.1155/2016/4095852.
22. Aghdam KA, Pielen A, Framme C, et al. Visual and anatomic outcomes after conversion to aflibercept in neovascular age-related macular degeneration: 12-month results[J]. Eur J Ophthalmol, 2016, 26(5): 473-478.DOI: 10.5301/ejo.5000757.
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