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

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, ther...

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Autores principales: Khachigian, Levon M., Liew, Gerald, Teo, Kelvin Y. C., Wong, Tien Y., Mitchell, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942398/
https://www.ncbi.nlm.nih.gov/pubmed/36810060
http://dx.doi.org/10.1186/s12967-023-03937-7
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author Khachigian, Levon M.
Liew, Gerald
Teo, Kelvin Y. C.
Wong, Tien Y.
Mitchell, Paul
author_facet Khachigian, Levon M.
Liew, Gerald
Teo, Kelvin Y. C.
Wong, Tien Y.
Mitchell, Paul
author_sort Khachigian, Levon M.
collection PubMed
description 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.
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spelling pubmed-99423982023-02-22 Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration Khachigian, Levon M. Liew, Gerald Teo, Kelvin Y. C. Wong, Tien Y. Mitchell, Paul J Transl Med Review 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. BioMed Central 2023-02-21 /pmc/articles/PMC9942398/ /pubmed/36810060 http://dx.doi.org/10.1186/s12967-023-03937-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Khachigian, Levon M.
Liew, Gerald
Teo, Kelvin Y. C.
Wong, Tien Y.
Mitchell, Paul
Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
title Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
title_full Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
title_fullStr Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
title_full_unstemmed Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
title_short Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
title_sort emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9942398/
https://www.ncbi.nlm.nih.gov/pubmed/36810060
http://dx.doi.org/10.1186/s12967-023-03937-7
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