Age-related macular degeneration caused by abnormal growth of blood vessels leaking damaging fluid into light-sensitive retina is known as wet macular degeneration, while anti-angiogenic drugs like VEGF inhibitors may slow progression by stopping new vessels from growing and improving vision by stopping further progression.

These treatments are typically administered monthly via injection into the eye; now ophthalmologists may be able to administer it continuously via an implanted device in the eye.

Eylea (Aflibercept)

Aflibercept is an anti-VEGF (vascular endothelial growth factor) medication, designed to inhibit VEGF-A and VEGF-B, two pro-angiogenic proteins which promote abnormal blood vessel formation in the retina. Its purpose is to treat wet (neovascular) age-related macular degeneration; an condition in which fluid leaks into the macula, leading to blurred vision. Aflibercept can also treat macular edema caused by retinal vein occlusions as well as diabetic macular edema.

Aflibercept has been proven to effectively improve visual acuity for patients with wet AMD, DME, and RVO. According to one study, those receiving Aflibercept experienced on average two additional lines on the ETDRS chart at one year as opposed to those treated only with laser photocoagulation alone. Furthermore, patients treated for RVO or DME who received Aflibercept showed significantly better outcomes compared with those treated solely by laser photocoagulation alone.

The FDA recently granted Aflibercept approval as a treatment for wet macular degeneration, one of the primary causes of blindness among people over 50. Aflibercept works to slow the onset of wet age-related macular degeneration by blocking leaky blood vessels forming centrally within retina, thus slowing its progress and halting further vision loss. Aflibercept can also be used in combination therapy with Ranibizumab for treating choroidal neovascularization and macular vein occlusion related diseases associated with AMD.

FDA has granted Aflibercept approval to reduce fluid build-up caused by diabetic macular edema. Roche originally sold this drug until Novartis acquired it in 2012. A variety of companies are working on biosimilar versions; Alteogen completed its phase 1 trial for an Aflibercept biosimilar FYB203 biosimilar in March 2021 while Formycon and Bioeq announced they would begin Phase 3 Equivalency Trial in August 2020.

The PBAC has recommended listing Aflibercept as an Authority Required benefit to treat subfoveal choroidal neovascularisation (CNV) associated with wet age-related macular degeneration (wet AMD). Aflibercept was approved for listing with reduced injection frequency and monitoring visits compared with other anti-VEGF agents, making it more cost-effective.

Susvimo (Ranibizumab)

Susvimo (Ranibizumab) is a prescription eye medicine designed to alleviate symptoms of wet macular degeneration, otherwise known as neovascular age-related macular degeneration. It works by blocking new blood vessel formation in the retina, thus slowing its progression. Susvimo comes as a refillable implant containing active medication slowly released over time into your eye – making this first-of-its-kind therapeutic approach potentially helping those living with wet AMD maintain their vision by only needing two treatments annually!

Susvimo received FDA approval in October 2021 as the only wet AMD treatment with a port delivery system since 2003 that continuously delivers medicine into the eye reducing frequent injections – typically once every month – required previously.

At the Phase 3 Archway Study primary analysis, patients treated with Susvimo achieved wet AMD vision gains comparable to those seen in the monthly ranibizumab injection arm (+0.2 to +0.5 eye chart letters). It can be surgically implanted into each eye during an outpatient procedure by a retina specialist and later refilled every six months for maximum efficacy.

Genentech, the manufacturer of Susvimo, boasts of its extensive clinical development program which encompasses Portal, Pagoda Pavilion Velodrome studies in both wet AMD and diabetic macular edema (DME) without DME. Furthermore, Genentech plans on seeking approval of Susvimo both in Europe and Japan.

Susvimo may cause serious side effects. These may include endophthalmitis (a medical emergency), bleeding inside the eye (vitreous hemorrhages) that can lead to temporary vision loss, erosions or retractions of the layer that covers white part of eye (conjunctival erosions or retractions) or blister-like collection of fluid on surface of eye (conjunctival bleb). Additional adverse reactions include headache, stomach upset, fatigue, rash and dizziness.

Before beginning treatment with Susvimo, it is essential that you inform your healthcare provider if any medications you are currently taking could increase the chance of blood clot formation (such as warfarin, low or regular doses of aspirin or nonsteroidal anti-inflammatory drugs like ibuprofen). Susvimo should not be taken by pregnant or breastfeeding women.

BEOVU (brolucizumab-dbll)

BEOVU is an eye injection administered directly into the eye once monthly to treat wet Age-Related Macular Degeneration, working by inhibiting a protein that causes new blood vessels to form. Two clinical trials using BEOVU demonstrated improved vision when compared to its control drug for wet AMD called Aflibercept; patients participating were of various races and ages and women and men alike participated.

Novartis reports that BEOVU provides a three-month dosing interval and greater fluid resolution compared with existing anti-VEGF therapies, along with similar safety profiles to Aflibercept. Serious side effects may include fast or irregular heartbeats; chest fluttering; shortness of breath and sudden dizziness or passing out; seek medical advice immediately if these occur.

VLTR-557

VLTR-557, Valitor’s long-acting anti-VEGF biologic in development for wet AMD treatment, demonstrated clinical efficacy for up to six months after a single intravitreal injection.

Valitor, an emerging biotechnology company engineering better medicines to overcome drug limitations, today announced that preclinical data on its next-generation anti-VEGF therapy for wet age-related macular degeneration will be presented at the 2023 Association for Research in Vision and Ophthalmology (ARVO) annual meeting taking place April 23-27 in New Orleans.

Regeneron Pharmaceuticals Inc. recently shared results of its Phase 2 LUNA trial of Ixo-vec for treating wet macular degeneration. Ixo-vec was shown to maintain visual gains for up to six months with just one injection, similar to that seen in its prior trials.

Clearside Biomedical, an eye-care therapeutics company, presented nonclinical data at ARVO 2023 related to their Phase 2b clinical trial of CLS-AX as an investigational treatment for neovascular age-related macular degeneration (nAMD). Their preliminary data indicated that SB15 had similar safety, immunogenicity, pharmacokinetics and pharmacodynamics as aflibercept up until week 56 in their PRISM study; their Dose Expansion Stage will open enrollment later this quarter.