Therapie der neovaskulären altersbedingten Makuladegeneration mit Ranibizumab/Lucentis™

Zusammenfassung

Dem vaskulären endothelialen Wachstumsfaktor (VEGF) wird zunehmend eine wichtige Rolle in der Pathogenese der altersbedingten Makuladegeneration (AMD) aufgrund seiner Permeabilitäts-induzierenden und angiogenen Eigenschaften zugeschrieben. Das Antikörperfragment Ranibizumab ist entwickelt worden, um alle VEGF-Isoformen zu binden und nach intravitrealer Injektion alle Netzhautschichten bis hin zum retinalen Pigmentepithel und Chorioidea zu erreichen. In Tiermodellen hat sich Ranibizumab als sicher und effektiv herausgestellt. Klinische Phase-I/II-Studien bei Patienten mit neovaskulärer AMD zeigten ein gutes Sicherheitsprofil sowie bei mehr als 90 % der Patienten eine Visusstabilisierung bis -verbesserung. Derzeit evaluieren klinische Zulassungsstudien die Behandlung der neovaskulären AMD mit Ranibizumab. Zudem werden Kombinationstherapien und neue Behandlungsstrategien mit dem Ziel einer längeren Effektdauer und einer verbesserten Effektivität in weiteren Studien untersucht. Die Anti-VEGF-Therapie mit Ranibizumab ist ein vielversprechender, neuer Therapieansatz bei der Behandlung der neovaskulären AMD.

Abstract

Vascular endothelial growth factor (VEGF) is considered to play an essential role in the pathogenesis of age-related macular degeneration due to its vascular permeability-inducing and angiogenic properties. Ranibizumab, a small antibody fragment designed to competitively bind all VEGF isoforms, passes after intravitreal injection all retinal layers reaching the retinal pigment epithelium-choroid complex. Experimental animal models showed the drug to be safe and effective. Subsequently, Phase I/II clinical trials conducted in patients with neovascular AMD demonstrated a good safety profile, and a significant functional benefit. Ranibizumab therapy repeated every four weeks for the treatment of neovascular AMD is currently in Phase III clinical trials. Combination therapy trials aiming for improved treatment durability and effectiveness are currently ongoing as well as new treatment strategies using intermittent, optical coherence tomography (OCT) guided therapy. Anti-VEGF therapy using Ranibizumab is a promising new treatment option for neovascular AMD.

Schlüsselwörter

Ranibizumab - vaskulärer endothelialer Wachstumsfaktor - altersbedingte Makuladegeneration - chorioidale Neovaskularisation - Angiogenese

Key words

Ranibizumab - vascular endothelial growth factor - age-related macular degeneration - choroidal neovascularization - angiogenesis

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