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A Review of Ranibizumab for the Treatment of Diabetic Retinopathy

INTRODUCTION: Laser photocoagulation has been the standard treatment for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) for several decades. The discovery of vascular endothelial growth factor (VEGF) and the subsequent determination of its critical role in the development...

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Autor principal: Stewart, Michael W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449302/
https://www.ncbi.nlm.nih.gov/pubmed/28324452
http://dx.doi.org/10.1007/s40123-017-0083-9
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author Stewart, Michael W.
author_facet Stewart, Michael W.
author_sort Stewart, Michael W.
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description INTRODUCTION: Laser photocoagulation has been the standard treatment for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) for several decades. The discovery of vascular endothelial growth factor (VEGF) and the subsequent determination of its critical role in the development DME and PDR has led to the development of VEGF inhibitory drugs. Ranibizumab was the first anti-VEGF drug approved for the treatment of both DME and diabetic retinopathy in eyes with DME. METHODS: Medline searches with the keywords "ranibizumab," "diabetic macular edema," and "proliferative diabetic retinopathy" were performed to identify pertinent pre-clinical studies and clinical trials. Top-line data, with emphasis on pivotal trials, was identified and incorporated into this manuscript. Findings from small uncontrolled trials were generally not used unless they filled important gaps in our understanding of anti-VEGF therapy. RESULTS: Ranibizumab is a recombinant humanized antibody fragment that binds all isoforms of VEGF-A with high affinity. Three parallel lines of clinical research have produced level I evidence supporting the superiority of ranibizumab over laser photocoagulation for the treatment of DME. Regular injections also lead to improvement in diabetic retinopathy severity scores in a large minority of eyes. Ranibizumab is effective for PDR and produces less visual field loss than laser photocoagulation. It has an excellent safety profile, with low incidence of ocular and systemic adverse events. CONCLUSIONS: Ranibizumab has become a frequently used first-line therapy for the treatment of DME. Emerging data suggest that it may become an important treatment for DR and PDR.
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spelling pubmed-54493022017-06-15 A Review of Ranibizumab for the Treatment of Diabetic Retinopathy Stewart, Michael W. Ophthalmol Ther Review INTRODUCTION: Laser photocoagulation has been the standard treatment for diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) for several decades. The discovery of vascular endothelial growth factor (VEGF) and the subsequent determination of its critical role in the development DME and PDR has led to the development of VEGF inhibitory drugs. Ranibizumab was the first anti-VEGF drug approved for the treatment of both DME and diabetic retinopathy in eyes with DME. METHODS: Medline searches with the keywords "ranibizumab," "diabetic macular edema," and "proliferative diabetic retinopathy" were performed to identify pertinent pre-clinical studies and clinical trials. Top-line data, with emphasis on pivotal trials, was identified and incorporated into this manuscript. Findings from small uncontrolled trials were generally not used unless they filled important gaps in our understanding of anti-VEGF therapy. RESULTS: Ranibizumab is a recombinant humanized antibody fragment that binds all isoforms of VEGF-A with high affinity. Three parallel lines of clinical research have produced level I evidence supporting the superiority of ranibizumab over laser photocoagulation for the treatment of DME. Regular injections also lead to improvement in diabetic retinopathy severity scores in a large minority of eyes. Ranibizumab is effective for PDR and produces less visual field loss than laser photocoagulation. It has an excellent safety profile, with low incidence of ocular and systemic adverse events. CONCLUSIONS: Ranibizumab has become a frequently used first-line therapy for the treatment of DME. Emerging data suggest that it may become an important treatment for DR and PDR. Springer Healthcare 2017-03-21 2017-06 /pmc/articles/PMC5449302/ /pubmed/28324452 http://dx.doi.org/10.1007/s40123-017-0083-9 Text en © The Author(s) 2017 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Stewart, Michael W.
A Review of Ranibizumab for the Treatment of Diabetic Retinopathy
title A Review of Ranibizumab for the Treatment of Diabetic Retinopathy
title_full A Review of Ranibizumab for the Treatment of Diabetic Retinopathy
title_fullStr A Review of Ranibizumab for the Treatment of Diabetic Retinopathy
title_full_unstemmed A Review of Ranibizumab for the Treatment of Diabetic Retinopathy
title_short A Review of Ranibizumab for the Treatment of Diabetic Retinopathy
title_sort review of ranibizumab for the treatment of diabetic retinopathy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449302/
https://www.ncbi.nlm.nih.gov/pubmed/28324452
http://dx.doi.org/10.1007/s40123-017-0083-9
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