Expert

Promising Treatment for Wet Age-Related Macular Degeneration

Scheie Eye Institute, University of Pennsylvania
A macular degeneration researcher holding a vial of brolucizumab for the treatment of wet macular degeneration.
Current treatments for wet age-related macular degeneration (AMD) require eye injections approximately every 4 – 8 weeks. Learn about a potential new treatment that may require less frequent injections.

Patients with wet AMD often ask, justifiably, if any new, longer lasting drugs will become available. While the current drugs, Lucentis®, Eylea®, and Avastin®, protect or improve vision in many patients, they generally need to be injected into the eye every 4-8 weeks. This requires patients and their families to make frequent trips to the ophthalmologist. In addition, there is some discomfort and risk, albeit very small, of complications associated with each injection.

Clinical Trial Results

Recent results from a phase III clinical trial, showed that a new drug called brolucizumab (pronounced broh – luh – siz – yoo – mab) given every 8-12 weeks, as needed, compared favorably to Eylea given every 8 weeks. Specifically, brolucizumab showed superior resolution of fluid that had leaked into the retina out of abnormal blood vessels during weeks 36 to 48 of the study. Importantly, with respect to visual acuity, brolucizumab was at least as good as those treated with Eylea.

How Does the Drug Work?

Like Lucentis, Avastin, and Eylea, brolucizumab inhibits a protein called VEGF, which is produced by retinas of patients with wet AMD and promotes the growth and leakage of abnormal blood vessels. Brolucizumab’s structure is a bit different though, which could influence its ability to penetrate the retina and target the VEGF protein. In addition, the dose of brolucizumab is higher than that of Lucentis, Avastin or Eylea, which may enable it to last longer in the eye. If FDA approval occurs as expected, then brolucizumab could become available this year.

Treatments in the Pipeline

Additional drugs for wet AMD that target VEGF and could last even longer than brolucizumab are in the pipeline. The port delivery system is a device implanted into the wall of the eye in the operating room that can store, and slowly release, Lucentis.  It can be refilled during an office visit. Abicipar is another drug that is injected into the eye to target VEGF. A phase II trial shows it can last as long as 12 weeks. RGX-314 is an anti-VEGF treatment delivered by gene therapy.  It has the potential to block VEGF for years following a surgical procedure in which a harmless virus, called adeno-associated virus (AAV), carrying the anti-VEGF gene, is injected under the retina.  

In conclusion, longer lasting anti-VEGF drugs are expected as soon as this year. Additional research on AMD is identifying new targets for wet and dry AMD, and some of these new drugs have made their way into ongoing clinical trials.

Resources:

This content was first posted on: March 4, 2019

The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for personalized advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product, therapy, or resources mentioned or listed in this article. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

These articles do not imply an endorsement of BrightFocus by the author or their institution, nor do they imply an endorsement of the institution or author by BrightFocus.

Some of the content may be adapted from other sources, which will be clearly identified within the article.

More Like This

  • An eye doctor viewing the retina of a young woman who has Best's disease.
    Expert

    Best's Disease

    There are several hereditary vision diseases that affect the macula, the central part of the retina that is responsible for providing sharp, clear, straight-ahead vision. One of them, called Best’s disease, is also known as vitelliform macular dystrophy.

    September 30, 2019
  • Medical illustration showing a drusen deposit in the retina. Illustration by Bob Morreale, provide courtesy of BrightFocus Foundation.
    Expert

    What Causes Macular Drusen?

    Drusen is a German word meaning “geode.” Since they are the defining feature of age-related macular degeneration (AMD), it’s important to understand what causes them to form. Understanding these mechanisms may lead to treatments that decrease the risk of disease progression.

    July 29, 2019
Don't miss out.
Receive research updates, inspiring stories, and expert advice
Keep me informed about: *
Please select at least one.
You must select at least one disease category.
Please enter your first name.
Please enter your last name.