Journal
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Volume 23, Issue 16, Pages -Publisher
MDPI
DOI: 10.3390/ijms23169424
Keywords
aflibercept; faricimab; anti-VEGF; angiopoietin-2; DME; diabetic macular edema; nAMD; neovascular age-related macular degeneration; Ang; Tie-2 pathway
Funding
- Poznan University of Medical Sciences
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Diabetic macular edema and neovascular age-related macular degeneration are common causes of blindness in developed countries. Current treatment with anti-VEGF agents has limitations, necessitating the development of new therapeutic methods. The Ang/Tie-2 pathway and the use of faricimab as a bispecific monoclonal antibody show promise in improving disease management and reducing treatment burden.
Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) are common retinal vascular diseases responsible for most blindness in the working-age and older population in developed countries. Currently, anti-VEGF agents that block VEGF family ligands, including ranibizumab, bevacizumab (off-label use), brolucizumab, and aflibercept, are the first-line treatment for nAMD and DME. However, due to the complex pathophysiological background of nAMD and DME, non-response, resistance during anti-VEGF therapy, and relapses of the disease are still observed. Moreover, frequent injections are a psychological and economic burden for patients, leading to inadequate adhesion to therapy and a higher risk of complications. Therefore, therapeutic methods are strongly needed to develop and improve, allowing for more satisfactory disease management and lower treatment burden. Currently, the Ang/Tie-2 pathway is a promising therapeutic target for retinal vascular diseases. Faricimab is the first bispecific monoclonal antibody for intravitreal use that can neutralize VEGF and Ang-2. Due to the prolonged activity, faricimab allows extending the interval between successive injections up to three or four months in nAMD and DME patients, which can be a significant benefit for patients and an alternative to implanted drug delivery systems.
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