Twenty Years of Anti-Vascular Endothelial Growth Factor Therapeutics in Neovascular Age-Related Macular Degeneration Treatment

International Journal of Molecular Sciences · 3 authors, 3 centres

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TL;DR

This narrative review traces two decades of anti-VEGF drug development for neovascular age-related macular degeneration, covering approved agents from pegaptanib through brolucizumab and conbercept. The review highlights that current anti-VEGF drugs remain insufficient for more than half of patients, driving ongoing efforts to improve efficacy, dosing intervals, and safety.

Full summary

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This narrative review by Moon et al. surveys anti-VEGF therapeutics for neovascular age-related macular degeneration (nAMD) developed over the past two decades. Key clinical trial comparisons are summarized, including equivalence between ranibizumab and bevacizumab in visual acuity outcomes, and between aflibercept and ranibizumab in efficacy and safety. Post-marketing safety concerns are noted for brolucizumab, with intraocular inflammation and retinal vascular occlusion reported at higher rates than with aflibercept.

STUDY TYPE

narrative_review

SPECIALTY

ophthalmology

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10454953

Twenty Years of Anti-Vascular Endothelial Growth Factor Therapeutics in Neovascular Age-Related Macular Degeneration Treatment

International Journal of Molecular Sciences

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ABSTRACT

Neovascular age-related macular degeneration (nAMD) is the primary disastrous retinal disease that leads to blindness in the elderly population. In the early 2000s, nAMD resulted in irreversible vision loss and blindness with no available treatment options. However, there have been breakthrough advances in the drug development of anti-angiogenic biological agents over the last two decades. The primary target molecule for treating nAMD is the vascular endothelial growth factor (VEGF), and there are currently several anti-VEGF drugs such as bevacizumab, ranibizumab, and aflibercept, which have made nAMD more manageable than before, thus preventing vision loss. Nevertheless, it should be noted that these anti-VEGF drugs for nAMD treatment are not effective in more than half of the patients, and even those who initially gain visual improvements lose their vision over time, along with potential deterioration in the geography of atrophy. As a result, there have been continuous endeavors to improve anti-VEGF agents through better efficacy, fewer doses, expanded intervals, and additional targets. This review describes past and current anti-VEGF therapeutics used to treat nAMD and outlines future directions to improve the effectiveness and safety of anti-VEGF agents.

CITATION EXPORT

Bo-Hyun Moon, Younghwa Kim, Soo-Young Kim. Twenty Years of Anti-Vascular Endothelial Growth Factor Therapeutics in Neovascular Age-Related Macular Degeneration Treatment. International Journal of Molecular Sciences. (2023). https://doi.org/10.3390/ijms241613004

AUTHORS

3 · 3 CENTRES

Bo-Hyun Moon, Younghwa Kim, Soo-Young Kim

1Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA; [email protected]
2Department of Paramedicine, Kyungil University, Gyeongsan-si 38428, Gyeongbuk, Republic of Korea
3Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA

EDITOR / REVIEWER

Diego García-Ayuso, Johnny Di Pierdomenico