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Angiogenesis in the eye underlies the major causes of blindness in both developed and developing nations: exudative age-related macular degeneration (AMD), proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), neovascular glaucoma, corneal neovascularization (trachoma), and pterygium. Presently approved anti-angiogenic therapies for ophthalmic conditions are biologic agents that inhibit VEGF. There are currently two approved antiangiogenic therapies for ophthalmic diseases: an anti-VEGF aptamer (pegaptanib, Macugen); and a Fab fragment of a monoclonal antibody directed against VEGF-A (ranibizumab, Lucentis).
Monoclonal Antibody Therapy
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| One monoclonal antibody therapy is approved to treat Age-related macular degeneration (AMD), a progessive eye diease that results in loss of central vision, and is the leading cause of severe vision loss in adults over the age of 65. The wet form of AMD accounts for 10% of cases, and is characterized by the abnormal growth of new blood vessels, which leak fluid and blood, inducing scare formation and destroying vision. |
Ranibizumab
(Lucentis) |
Description |
| Genentech |
A recombinant humanized IgG1 kappa monoclonal antibody fragment that binds vascular endothelial growth factor-A (VEGF-A) and cleavage products, and prevents their interaction with VEGF receptors (VEGFR-1 and VEGFR-2), thereby inhibiting endothelial cell proliferation, angiogenesis, and vasular leakage in the retina and choroidal layers.
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| Approved
indications: |
1. Neovascular (wet) age-related macular degeneration,
2. macular edema after retinal vein occlusion
- Administered by intravitreal injection.
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Aptamer
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Pegaptanib
(Macugen) |
Description |
OSI Eyetech
Pfizer |
A pegylated modified oligonucleotide (aptamer) which adopts a three dimentional conformation that enables it to bind to extracellular VEGF, thereby inhibiting its binding to VEGF receptors and suppressing pathological neovascularization. |
| Approved
indications: |
Neovascular (wet) age-related macular degeneration
- Administered by intravitreal injection.
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Last updated September 7, 2011
References:
Andreoli CM, Miller JW. Antivascular endothelial growth factor therapy for ocular neovascular disease. Cum op in Opthalmol 2007; 18(6):502-8
Jager RD, Mieler WF, Miller JW. Age-related macular degeneration. N.Engl. J. Med. 2008;358(24):2606-17
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