干性老年性黄斑变性药物治疗前景如何?

IF 0.9 Q4 OPHTHALMOLOGY

Expert Review of Ophthalmology Pub Date : 2023-10-04 DOI:10.1080/17469899.2023.2267179

Federico Rissotto, Riccardo Sacconi, Aurelio Apuzzo, Gloria Oldoni, Emanuele Fusi, Andrea Servillo, Francesco Bandello, Giuseppe Querques

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引用次数: 0

摘要

摘要简介年龄相关性黄斑变性(Age-related Macular Degeneration, AMD)是导致老年人视力不可逆性下降的主要原因之一。干性AMD是最常见的AMD形式，其特征是光感受器丧失，视网膜色素上皮(RPE)功能障碍和视网膜变性。尽管在过去的几年中进行了一些临床试验，并研究了许多治疗性分子来治疗干性黄斑变性，但目前其治疗仍不令人满意。在这篇综述中，我们报告和分析了迄今为止已经研究和开展的最重要的分子和治疗方法，以及未来治疗这种复杂严重疾病的可能希望。我们在分析文献后提供了一篇叙述性的综述，我们选择了120多篇论文来发表这篇文章。虽然在2023年已经进行了第一个FDA批准的药物，但在开发有效的治疗干性amd的方法上还有很长的路要走。在未来，对其发病机制的更好理解可能会导致靶向或基因治疗的发展，这些治疗不仅对视网膜有解剖作用，而且对功能也有影响。关键词:年龄相关性黄斑变性;地理萎缩症;补体抑制剂;神经保护;在最终出版版本记录(VoR)之前，将对该手稿进行编辑、排版和审查。在制作和印前，可能会发现可能影响内容的错误，所有适用于期刊的法律免责声明也与这些版本有关。本文综述了迄今为止治疗干性amd的重要分子和试验。AREDS营养补充仍然是干性amd护理的标准。2023年，FDA批准了首个经证实有效的治疗干性amd的药物:Pegcetacoplan和Avacincaptad Pegol。在未来，一种专注于预防和阻断干性amd发展的基因治疗可能是最有效的治疗方法，但目前，它的发展处于胚胎阶段。Sacconi有以下披露:Allergan Inc .， Bayer sher- pharma, Medivis, Novartis, Zeiss。G Querques有以下披露:Alimera Sciences, Allergan Inc .， Amgen, Bayer sher- Pharma，海德堡，KBH, LEH Pharma, Lumithera，诺华，山德士，Sifi, soft - fidea，蔡司。F Bandello有以下披露:Alcon(顾问)、Alimera Sciences(顾问)、Allergan Inc(顾问)、Farmila-Thea(顾问)、Bayer sherling -Pharma(顾问)、Bausch and lomgenentech(顾问)、Hoffmann-La-Roche(顾问)、Novagali Pharma(顾问)、Novartis(顾问)、Sanofi-Aventis(顾问)、Thrombogenics(顾问)、Zeiss(顾问)。除了披露的内容外，作者与任何组织或实体没有其他相关关系或财务参与，这些组织或实体与稿件中讨论的主题或材料有经济利益或经济冲突。审稿人披露本文的每位审稿人没有相关的财务或其他关系需要披露。图1:通过多彩图和OCT显示的中度AMD，黄色箭头表示一组结节，蓝色箭头表示多彩图和OCT同时显示的结节。图2:该图像显示了典型的遗传算法模式，由不同的滤波器指出。图3:通过红外、多色和OCT图像显示的中央凹保留遗传算法显示完整尺寸图4:图像显示主要补体抑制剂药物及其补体级联相应靶标显示完整尺寸附加信息

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What is on the horizon for dry age-related macular degeneration drug treatment?

ABSTRACTIntroduction Age-related Macular Degeneration (AMD) is one of the leading causes of irreversible visual acuity reduction among the elderly population. Dry AMD, the most frequent AMD form, is characterized by photoreceptor loss, Retinal Pigmented Epithelium (RPE) dysfunction and retinal degeneration. Although in the last years several clinical trials have been carried out and many therapeutic molecules have been examined to treat dry AMD, currently its treatment remains unsatisfactory.Areas covered In this review we report and analyze the most important molecules and treatment that have been studied and carried out till nowadays, and the future therapies that may be a hope in this complex and serious disease. We have provided a narrative review after having analyzed the literature and we have selected more than 120 papers to deliver this article.Expert opinion Although in 2023 has been carried out the first FDA approved drugs, there is still a long way to go in developing effective therapies for dry-AMD. In the future, a better understanding of its pathogenesis may lead to the development of targeted or genetic therapies that not only have an anatomical effect on the retina but also have a functional impact.KEYWORDS: Age related macular degenerationGeographic atrophydrusencomplement inhibitorsneuroprotectiongenetic therapyintravitreal injectionDisclaimerAs a service to authors and researchers we are providing this version of an accepted manuscript (AM). Copyediting, typesetting, and review of the resulting proofs will be undertaken on this manuscript before final publication of the Version of Record (VoR). During production and pre-press, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal relate to these versions also. Article highlightsIn this review we have summarized the most important molecules and trials that have been carried out till now in the attempt to treat dry-AMD.AREDS nutritional supplementation remains the standard of care for dry-AMD.In 2023 FDA has approved the first proven effect therapies for dry-AMD: Pegcetacoplan, and Avacincaptad Pegol.In the future, a genetic therapy focused on preventing and blocking the development of dry-AMD could be the most effective treatment, but at the present time, its development is at the embryonic stage.Declaration of InterestsR Sacconi has the following disclosures: Allergan Inc, Bayer Shering-Pharma, Medivis, Novartis, Zeiss.G Querques has the following disclosures: Alimera Sciences, Allergan Inc, Amgen, Bayer Shering-Pharma, Heidelberg, KBH, LEH Pharma, Lumithera, Novartis, Sandoz, Sifi, Sooft-Fidea, Zeiss.F Bandello has the following disclosures: Alcon (consultant), Alimera Sciences (consultant), Allergan Inc (consultant), Farmila-Thea (consultant), Bayer Shering-Pharma (consultant), Bausch and Lomb Genentech (consultant), Hoffmann-La-Roche (consultant), Novagali Pharma (consultant), Novartis (consultant), Sanofi-Aventis (consultant), Thrombogenics (consultant), Zeiss (consultant).The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Figure 1: The image shows an intermediate AMD through Multicolor image and OCT. Yellow arrows indicate a group of drusen, blue arrow indicates a drusen shown both on Multicolor and OCT scan.Display full sizeFigure 2: The image shows the typical GA pattern, pointed out by different filters.Display full sizeFigure 3: The image shows a foveal sparing GA through infra-red, multicolor and OCT imagesDisplay full sizeFigure 4: The image shows the main complement inhibitors drugs and their complement cascade corresponding targetDisplay full sizeAdditional informationFundingThis paper was not funded

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来源期刊

Expert Review of Ophthalmology Health Professions-Optometry

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： The worldwide problem of visual impairment is set to increase, as we are seeing increased longevity in developed countries. This will produce a crisis in vision care unless concerted action is taken. The substantial value that ophthalmic interventions confer to patients with eye diseases has led to intense research efforts in this area in recent years, with corresponding improvements in treatment, ophthalmic instrumentation and surgical techniques. As a result, the future for ophthalmology holds great promise as further exciting and innovative developments unfold.