Approved treatments for neovascular age-related macular degeneration: current safety and future directions

Expert Opin Drug Saf. 2024 Sep;23(9):1109-1114. doi: 10.1080/14740338.2024.2387318. Epub 2024 Aug 5.

Abstract

Introduction: Age-related macular degeneration (AMD) is a progressive retinal degenerative disease that is implicated as one of the leading causes of visual impairment in the elderly population. Vascular endothelial growth factor (VEGF) has been identified as the main driver of AMD, and various therapeutics have revolutionized the treatment and management of neovascular AMD (nAMD) with favorable visual and anatomical outcomes.

Areas covered: Physicians have a variety of approved therapeutics in their arsenal for patients with varying disease progression and patient-specific needs, with the ultimate goal of achieving optimal visual and anatomic outcomes. The literature search was conducted using PubMed, Google Scholar, and sources from companies' websites, allowing us to locate findings recently presented at conferences.

Expert opinion: Scientific advancements in the field have led to newly approved therapeutics and devices, such as the port-delivery system with ranibizumab (PDS), and further investigation is ongoing in the realm of gene therapy for retinal diseases. In addition to efficacy and durability, newer agents must have comparable safety profiles to older agents in order to be used broadly. These options introduce a level of complexity in nAMD treatment; however, physicians to personalize treatment to improve vision in nAMD patients and reduce treatment burden overall.

Keywords: Age-related macular degeneration (nAMD); intravitreal injections; safety; step therapy; treatment burden; vascular endothelial growth factor (VEGF).

Publication types

  • Review

MeSH terms

  • Aged
  • Angiogenesis Inhibitors* / administration & dosage
  • Angiogenesis Inhibitors* / adverse effects
  • Angiogenesis Inhibitors* / pharmacology
  • Animals
  • Disease Progression
  • Drug Delivery Systems
  • Genetic Therapy* / methods
  • Humans
  • Macular Degeneration* / drug therapy
  • Ranibizumab / administration & dosage
  • Ranibizumab / adverse effects
  • Vascular Endothelial Growth Factor A* / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab
  • VEGFA protein, human