Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration

Journal of Translational Medicine

Review

Paul Mitchell¹  Gerald Liew¹  Kelvin Y. C. Teo²  Tien Y. Wong³  Levon M. Khachigian⁴ 

[1] Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia;Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore;Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore;Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore;Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore;Tsinghua Medicine, Tsinghua University, Beijing, China;Vascular Biology and Translational Research, Faculty of Medicine and Health, School of Medical Sciences, University of New South Wales, 2052, Sydney, NSW, Australia;

关键词: Neovascular age-related macular degeneration;    Vascular endothelial growth factor;    VEGF receptors;    Anti-VEGF therapy;    Aflibercept;    Ranibizumab;    Bevacizumab;    Brolucizumab;    Faricimab;   

DOI  :  10.1186/s12967-023-03937-7

 received in 2022-11-01, accepted in 2023-01-27,  发布年份 2023

来源: Springer

【 摘 要 】

Neovascular age-related macular degeneration (nAMD) is a major cause of visual impairment and blindness. Anti-vascular endothelial growth factor (VEGF) agents, such as ranibizumab, bevacizumab, aflibercept, brolucizumab and faricimab have revolutionized the clinical management of nAMD. However, there remains an unmet clinical need for new and improved therapies for nAMD, since many patients do not respond optimally, may lose response over time or exhibit sub-optimal durability, impacting on real world effectiveness. Evidence is emerging that targeting VEGF-A alone, as most agents have done until recently, may be insufficient and agents that target multiple pathways (e.g., aflibercept, faricimab and others in development) may be more efficacious. This article reviews issues and limitations that have arisen from the use of existing anti-VEGF agents, and argues that the future may lie in multi-targeted therapies including alternative agents and modalities that target both the VEGF ligand/receptor system as well as other pathways.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1