Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept

Michael W StewartCollege of Medicine, Mayo Clinic, Jacksonville, FL, USAAbstract: Age-related macular degeneration (AMD) has become a major public health problem and a leading cause of blindness in industrialized nations. AMD results from the ageing eye&#39;s inability to metabolize and disp...

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Autor principal:	Stewart MW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b3d749c910ee414997212020ae887f00
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spelling	oai:doaj.org-article:b3d749c910ee414997212020ae887f002021-12-02T01:27:32ZClinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept1177-54671177-5483https://doaj.org/article/b3d749c910ee414997212020ae887f002012-07-01T00:00:00Zhttp://www.dovepress.com/clinical-and-differential-utility-of-vegf-inhibitors-in-wet-age-relate-a10519https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Michael W StewartCollege of Medicine, Mayo Clinic, Jacksonville, FL, USAAbstract: Age-related macular degeneration (AMD) has become a major public health problem and a leading cause of blindness in industrialized nations. AMD results from the ageing eye&#39;s inability to metabolize and dispose completely of photoreceptor outer segments and other waste products. As a result, lipids, particularly apolipoproteins, accumulate within Bruch&#39;s membrane, leading to chronic ischemia and inflammation. The subsequent upregulation of inflammatory cytokines and growth factors, including vascular endothelial growth factor (VEGF), induces the growth of neovascular membranes from the choriocapillaris into the subretinal or subretinal pigment epithelium spaces. To counter this, intravitreally administered drugs (pegaptanib, bevacizumab, ranibizumab) that specifically target VEGF have become the standard treatment for exudative AMD. Aflibercept, a recently approved fusion protein, binds to all isoforms of both VEGF-A and placental growth factor with high affinity. Phase III trials showed that monthly or every other month injections of aflibercept prevent vision loss (fewer than 15 letters) in 95% of patients. Additionally, aflibercept injections every 4 or 8 weeks produce average vision gains of 6.9 letters to 10.9 letters, comparable with those achieved with monthly ranibizumab. After one year of regularly administered aflibercept injections, patients required an average of only 4.2 injections during the second year. Aflibercept promises to decrease the injection frequency required for many patients and appears to serve as an effective &ldquo;salvage&rdquo; therapy for patients who respond poorly to other anti-VEGF drugs.Keywords: age-related macular degeneration, choroidal neovascularization, vascular endothelial growth factor, aflibercept, ranibizumab, bevacizumab, VEGF trapStewart MWDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1175-1186 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Stewart MW Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept
description	Michael W StewartCollege of Medicine, Mayo Clinic, Jacksonville, FL, USAAbstract: Age-related macular degeneration (AMD) has become a major public health problem and a leading cause of blindness in industrialized nations. AMD results from the ageing eye&#39;s inability to metabolize and dispose completely of photoreceptor outer segments and other waste products. As a result, lipids, particularly apolipoproteins, accumulate within Bruch&#39;s membrane, leading to chronic ischemia and inflammation. The subsequent upregulation of inflammatory cytokines and growth factors, including vascular endothelial growth factor (VEGF), induces the growth of neovascular membranes from the choriocapillaris into the subretinal or subretinal pigment epithelium spaces. To counter this, intravitreally administered drugs (pegaptanib, bevacizumab, ranibizumab) that specifically target VEGF have become the standard treatment for exudative AMD. Aflibercept, a recently approved fusion protein, binds to all isoforms of both VEGF-A and placental growth factor with high affinity. Phase III trials showed that monthly or every other month injections of aflibercept prevent vision loss (fewer than 15 letters) in 95% of patients. Additionally, aflibercept injections every 4 or 8 weeks produce average vision gains of 6.9 letters to 10.9 letters, comparable with those achieved with monthly ranibizumab. After one year of regularly administered aflibercept injections, patients required an average of only 4.2 injections during the second year. Aflibercept promises to decrease the injection frequency required for many patients and appears to serve as an effective &ldquo;salvage&rdquo; therapy for patients who respond poorly to other anti-VEGF drugs.Keywords: age-related macular degeneration, choroidal neovascularization, vascular endothelial growth factor, aflibercept, ranibizumab, bevacizumab, VEGF trap
format	article
author	Stewart MW
author_facet	Stewart MW
author_sort	Stewart MW
title	Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept
title_short	Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept
title_full	Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept
title_fullStr	Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept
title_full_unstemmed	Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept
title_sort	clinical and differential utility of vegf inhibitors in wet age-related macular degeneration: focus on aflibercept
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/b3d749c910ee414997212020ae887f00
work_keys_str_mv	AT stewartmw clinicalanddifferentialutilityofvegfinhibitorsinwetagerelatedmaculardegenerationfocusonaflibercept
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Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept

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