Abicipar pegol: an investigational anti-VEGF agent for the treatment of wet age-related macular degeneration

ABSTRACT

Introduction

Several approaches have been investigated for the management of wet age-related macular degeneration (w-AMD); however, the first-line treatment option for w-AMD currently constitutes anti-VEGF agents. Abicipar pegol is a designed ankyrin repeat protein (DARPin), a novel, promising anti-VEGF agent for the treatment of w-AMD and is reviewed in this article.

Areas covered

We discuss the pharmacokinetic, pharmacodynamic, clinical, and tolerability profile revealed by phase II REACH, CYPRESS, and BAMBOO and phase III CEDAR and SEQUOIA Trials. These two latter phase III trials revealed the non-inferiority of abicipar pegol administered with a bimonthly and quarterly regimen when compared with monthly ranibizumab.

Expert opinion

Abicipar pegol has been proven to be an emerging, promising anti-VEGF agent in the management of w-AMD. The possibility of adopting a quarterly regimen would allow a decrease in treatment burden and improve patient compliance; however, further larger-scale studies should better characterize abicipar pegol clinical efficacy over longer follow-up periods.

KEYWORDS:

• Macular degeneration
• retina
• abicipar pegol
• anti-VEGF drugs
• intravitreal injections

Article highlights

• Abicipar pegol belongs to the family of the designed ankyrin repeat proteins (DARPin) which are composed of several ankyrin repeat bonds to a 20-kDa polyethylene glycol (PEG) tail.

• In phase II REACH Study, abicipar pegol showed a non-inferiority profile compared with ranibizumab in terms of best-corrected visual acuity (BCVA) and central retinal thickness (CRT). In the BAMBOO and CYPRESS studies, similar results were reported.

• Extrapolated data from phase III CEDAR and SEQUOIA Trials revealed the possibility of administering abicipar pegol with a quarterly regimen without decreasing its clinical efficacy showed by more sustained treatment protocols.

• Despite some safety concerns raised from the CEDAR and SEQUOIA trials, the MAPLE study showed an acceptable incidence of intraocular inflammation in abicipar pegol-treated patients; most of the cases were a mild-to-moderate severity.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.