Long-acting delivery and therapies for neovascular age-related macular degeneration.

IF 3.6 3区 医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
Expert Opinion on Biological Therapy Pub Date : 2024-08-01 Epub Date: 2024-07-22 DOI:10.1080/14712598.2024.2374869
Lucas W Rowe, Thomas A Ciulla
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引用次数: 0

Abstract

Introduction: Neovascular age-related macular degeneration (nAMD) represents a leading cause of severe visual impairment in individuals over 50 years of age in developed nations. Intravitreal anti-vascular endothelial growth factor (VEGF) injections have become the standard of care for treating nAMD; however, monthly or bimonthly dosing represents significant time and cost burden due to the disease's chronic nature and limited medication half-life.

Areas covered: This review summarizes innovative therapeutics and delivery methods for nAMD. Emerging methods for extended drug delivery include high molar concentration anti-VEGF drugs, intravitreal sustained-release polymers and devices, reservoirs for intravitreal delivery, suprachoroidal delivery of small molecular suspensions and gene therapy biofactories. In addition to VEGF-A, therapies targeting inhibition of VEGF-C and D, the angiopoetin-2 (Ang-2)/Tie-2 pathway, tyrosine kinases, and integrins are reviewed.

Expert opinion: The evolving therapeutic landscape of nAMD is rapidly expanding our toolkit for effective and durable treatment. Recent FDA approvals of faricimab (Vabysmo) and high-dose aflibercept (Eylea HD) for nAMD with potential extension of injection intervals up to four months have been promising developments for patients and providers alike. Further research and innovation, including novel delivery techniques and pharmacologic targets, is necessary to validate the efficacy of developing therapeutics and characterize real-world outcomes, demonstrating promise in expanding treatment durability.

新生血管性老年黄斑变性的长效给药和疗法。
导言:新生血管性老年性黄斑变性(nAMD)是发达国家 50 岁以上人群视力严重受损的主要原因。视网膜内注射抗血管内皮生长因子(VEGF)已成为治疗 nAMD 的标准疗法;然而,由于该疾病的慢性性质和有限的药物半衰期,每月或每两个月一次的用药给患者带来了巨大的时间和成本负担:本综述概述了治疗非急性脑血管病的创新疗法和给药方法。新出现的延长给药方法包括高摩尔浓度抗血管内皮生长因子药物、玻璃体内持续释放装置、玻璃体内给药储库以及基因治疗生物制剂。除血管内皮生长因子-A外,还综述了以抑制血管内皮生长因子-C和D、血管生成素-2(Ang-2)/Tie-2通路、酪氨酸激酶和整合素为目标的疗法:不断发展的非血管内皮生长因子疾病治疗方法正在迅速扩大我们有效和持久治疗的工具包。最近,美国食品与药物管理局批准法利西单抗(Vabysmo)和高剂量阿弗利百普(Eylea HD)用于非视网膜缺损,并可能将注射间隔延长至四个月,这对患者和医疗机构来说都是充满希望的发展。有必要开展进一步的研究和创新,包括新型给药技术和药理靶点,以验证开发中疗法的疗效,并确定实际结果的特征。
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来源期刊
Expert Opinion on Biological Therapy
Expert Opinion on Biological Therapy 医学-生物工程与应用微生物
CiteScore
8.60
自引率
0.00%
发文量
96
审稿时长
3-8 weeks
期刊介绍: Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection format and includes the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results; Article Highlights – an executive summary of the author’s most critical points.
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