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Aflibercept in wet AMD: specific role and optimal use.
Drug Des Devel Ther 2013; 7:711-22DD

Abstract

BACKGROUND

Vascular endothelial growth factor (VEGF) is a naturally occurring glycoprotein in the body that acts as a growth factor for endothelial cells. It regulates angiogenesis, enhances vascular permeability, and plays a major role in wet age-related macular degeneration. The consistent association between choroidal neovascularization and increased VEGF expression provides a strong reason for exploring the therapeutic potential of anti-VEGF agents in the treatment of this disorder. Blockade of VEGF activity is currently the most effective strategy for arresting choroidal angiogenesis and reducing vascular permeability, which is frequently the main cause of visual acuity deterioration. In recent years, a number of other molecules have been developed to increase the efficacy and to prolong the durability of the anti-VEGF effect. Aflibercept (EYLEA®; Regeneron Pharmaceutical Inc and Bayer), also named VEGF Trap-eye, is the most recent member of the anti-VEGF armamentarium that was approved by the US Food and Drug Administration in November 2011. Because of its high binding affinity and long duration of action, this drug is considered to be a promising clinically proven anti-VEGF agent for the treatment of wet maculopathy.

OBJECTIVE

This article reviews the current literature and clinical trial data regarding the efficacy and the pharmacological properties of VEGF-Trap eye and describes the possible advantages of its use over the currently used "older" anti-VEGF drugs.

METHODS

For this review, a search of PubMed from January 1989 to May 2013 was performed using the following terms (or combination of terms): vascular endothelial growth factors, VEGF, age-related macular degeneration, VEGF-Trap eye in wet AMD, VEGF-Trap eye in diabetic retinopathy, VEGF-Trap eye in retinal vein occlusions, aflibercept. Studies were limited to those published in English.

RESULTS AND CONCLUSION

Two Phase III clinical trials, VEGF Trap-eye Investigation of Efficacy and Safety in Wet AMD (VIEW) 1 and 2, comparing VEGF Trap-eye to ranibizumab demonstrated the noninferiority of this novel compound. The clinical equivalence of this compound against ranibizumab is maintained even when the injections are administered at 8-week intervals, which indicates the potential to reduce the risk of monthly intravitreal injections and the burden of monthly monitoring.

Authors+Show Affiliations

Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, Ophthalmology Clinic, University of Brescia, Piazzale Spedali Civili 1, Brescia, Italy. semeraro@med.unibs.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

23990705

Citation

Semeraro, F, et al. "Aflibercept in Wet AMD: Specific Role and Optimal Use." Drug Design, Development and Therapy, vol. 7, 2013, pp. 711-22.
Semeraro F, Morescalchi F, Duse S, et al. Aflibercept in wet AMD: specific role and optimal use. Drug Des Devel Ther. 2013;7:711-22.
Semeraro, F., Morescalchi, F., Duse, S., Parmeggiani, F., Gambicorti, E., & Costagliola, C. (2013). Aflibercept in wet AMD: specific role and optimal use. Drug Design, Development and Therapy, 7, pp. 711-22. doi:10.2147/DDDT.S40215.
Semeraro F, et al. Aflibercept in Wet AMD: Specific Role and Optimal Use. Drug Des Devel Ther. 2013;7:711-22. PubMed PMID: 23990705.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aflibercept in wet AMD: specific role and optimal use. AU - Semeraro,F, AU - Morescalchi,F, AU - Duse,S, AU - Parmeggiani,F, AU - Gambicorti,E, AU - Costagliola,C, Y1 - 2013/08/05/ PY - 2013/8/31/entrez PY - 2013/8/31/pubmed PY - 2014/5/6/medline KW - AMD KW - VEGF KW - VEGF inhibition KW - VEGF-Trap eye KW - aflibercept KW - neovascularization SP - 711 EP - 22 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 7 N2 - BACKGROUND: Vascular endothelial growth factor (VEGF) is a naturally occurring glycoprotein in the body that acts as a growth factor for endothelial cells. It regulates angiogenesis, enhances vascular permeability, and plays a major role in wet age-related macular degeneration. The consistent association between choroidal neovascularization and increased VEGF expression provides a strong reason for exploring the therapeutic potential of anti-VEGF agents in the treatment of this disorder. Blockade of VEGF activity is currently the most effective strategy for arresting choroidal angiogenesis and reducing vascular permeability, which is frequently the main cause of visual acuity deterioration. In recent years, a number of other molecules have been developed to increase the efficacy and to prolong the durability of the anti-VEGF effect. Aflibercept (EYLEA®; Regeneron Pharmaceutical Inc and Bayer), also named VEGF Trap-eye, is the most recent member of the anti-VEGF armamentarium that was approved by the US Food and Drug Administration in November 2011. Because of its high binding affinity and long duration of action, this drug is considered to be a promising clinically proven anti-VEGF agent for the treatment of wet maculopathy. OBJECTIVE: This article reviews the current literature and clinical trial data regarding the efficacy and the pharmacological properties of VEGF-Trap eye and describes the possible advantages of its use over the currently used "older" anti-VEGF drugs. METHODS: For this review, a search of PubMed from January 1989 to May 2013 was performed using the following terms (or combination of terms): vascular endothelial growth factors, VEGF, age-related macular degeneration, VEGF-Trap eye in wet AMD, VEGF-Trap eye in diabetic retinopathy, VEGF-Trap eye in retinal vein occlusions, aflibercept. Studies were limited to those published in English. RESULTS AND CONCLUSION: Two Phase III clinical trials, VEGF Trap-eye Investigation of Efficacy and Safety in Wet AMD (VIEW) 1 and 2, comparing VEGF Trap-eye to ranibizumab demonstrated the noninferiority of this novel compound. The clinical equivalence of this compound against ranibizumab is maintained even when the injections are administered at 8-week intervals, which indicates the potential to reduce the risk of monthly intravitreal injections and the burden of monthly monitoring. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/23990705/Aflibercept_in_wet_AMD:_specific_role_and_optimal_use_ L2 - https://dx.doi.org/10.2147/DDDT.S40215 DB - PRIME DP - Unbound Medicine ER -