VEGF inhibition: latest developments

Abstract

Rapid advances have been made in the field of macular degeneration in recent years. The treatment of this condition has been revolutionized with the introduction of VEGF inhibition therapy – first pegaptanib sodium and, more recently, ranibizumab and bevacizumab. However, the pivotal clinical trials have revealed the need for multiple treatments over prolonged periods of time. Thus, the delivery of VEGF inhibition therapies regardless of the cost of the drug has important economic implications in a world where a growing elderly population has placed an enormous strain on healthcare resources. This economic burden is due to the fact that the number of patients who would potentially benefit is high, there is a necessity for repeated drug delivery and monitoring and there is no clear indication of when treatment and monitoring may be stopped. Future studies should be designed to address these uncertainties and provide guidance to clinicians on how to achieve optimal management without compromising on functional outcomes.

Keywords::

• anti-VEGF
• bevacizumab
• neovascular macular degeneration
• pegaptanib
• photodynamic therapy
• ranibizumab
• receptor tyrosine kinase inhibitor
• siRNA
• VEGF factor
• VEGF-trap

Financial disclosure

Usha Chakravarthy has been on the scientific advisory boards of Novartis, Pfizer, Genaera, Jerini and Eyetech, all of whom have proprietary interests in agents that inhibit VEGF. She was a member of the VISION trials study group. She has received financial assistance from some of the above for speaking at conferences. Clara E McAvoy has been involved in clinical trials sponsored by Novartis and Pfizer.