Soon, patients suffering from wet age-related macular degeneration may no longer require monthly injections due to scientists uncovering its cellular source.

This activity will explore existing and emerging therapies for ARMD subtypes, with focus on safety and efficacy profiles as well as testing strategies that may assist management plans for ARMD. Additionally, testing strategies which may guide treatment plans will also be discussed.

Vabysmo

Vabysmo is an injectable monoclonal antibody designed to inhibit two disease pathways linked to vision-threatening retinal vascular diseases, specifically targeting vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2). By blocking certain pathways, this drug stabilizes blood vessels and improves visual acuity. Administered intravitreally via injection by an ophthalmologist, it has recently been approved by the FDA as treatment for macular edema following retinal vein occlusion (RVO). Robyn Guymer, MD from the Centre for Eye Research Australia and Royal Victorian Eye and Ear Hospital in Melbourne presented results of her new study at an Angiogenesis, Exudation, and Degeneration virtual meeting hosted by Bascom Palmer Eye Institute.

The YOSEMITE and RHINE phase 3 studies assessed the efficacy of faricimab-svoa (Vabysmo, Roche) compared to aflibercept-sipilolimus (Eylea, Regeneron Pharmaceuticals). Results from both trials demonstrated that Vabysmo provided early and sustained improvement for central macular edema associated with center-involved RVO, meeting primary endpoints such as non-inferior changes in best-corrected visual acuity at 24 weeks; additionally it was well tolerated by participants.

Roche has received approval for their supplemental biologics license application to treat wet macular degeneration from the Food and Drug Administration, with approval anticipated in 2022. They expect approval alongside several other anti-VEGF agents such as Aflibercept by Novartis or bevacizumab by Roche – such as single molecule therapies like theirs that use single molecules such as bevacizumab which inhibit production of VEGF – making their drug easier than many of its rivals in terms of use and risk of complications compared to anti-VEGF drugs – making this treatment ideal for people suffering severe macular edema who may not tolerate repeated treatments due to complications caused by anti-VEGF therapies used by other agents such as Aflibercept by Novartis or bevacizumab used against production of VEGF production by other agents such as Aflibercept by Roche which inhibit production of VEGF production by other agents such as Aflibercept from Novartis bevacizumab from Novartis from Novartis; all three will compete against these products from Roche who expect approval in 2022; these treatments will compete with several products that inhibit production of VEGF such as Aflibercept and Novartis’ bevacizumab as they inhibit its production VEGF inhibition such as bevacizumab by Novartis, including Novartis’ bevacizumab by inhibiting its production, including Novartis bevacizumab as well as Novartis’ bevacizumab; both drugs being single molecule therapy makes it simpler than its competitors being single allowing delivery every four weeks or less frequent treatments offered from rival companies that inhibit production VEGF inhibitors such as Novartis bevacizumab being anti-VEGF treatments from Novartis bevacizumab by Novartis’ bevacizumab which both inhibit its production such as bevacizumab used against other inhibitors such as bevacizumab; their bevacizumab by being delivered every four weeks or others offered; making its risk reduced which have higher risks risks such. It makes its lower risks also being administered once with possible. Novartis bevaci be used against. Novartis bevaci based. Novartis bevaci. Novartis offering Nov VEGF inhibitors than bevici ; be va. Novarti with respect also having less risk risks making its competitor Nov. Nov. Bevaci. Also great choice due its lower risks than other anti VEGF products, like Aflibercept for example being delivered every four weeks or less risk. bevacizamab for be! bevaci vevaci if given it. Bevaci. Bevaci. bevaci compared anti vcizzo MACRA in its own be – be. bevaci as it too complicated treatments when administered repeatedly with reduced complications than these same thing could easily tolerate repeated anti – possibly being introduced when applied when used and thus making other anti…, making this therapy may tolerated so..

Susvimo

Genentech’s Susvimo port delivery system with ranibizumab was approved for treatment of wet macular degeneration in October 2021. The implant, surgically placed during an outpatient procedure and then periodically refilled every six months, reduces anti-VEGF injections over time while increasing patient satisfaction, as evidenced by results of ARCHWAY trial phase III.

Research into retinal diseases focuses on uncovering their root causes at a cellular level, with researchers working towards early detection of geographic atrophy (GA) and wet AMD as well as anticipating progression to disease progression and finding treatments for inheritable forms of these conditions.

At the Angiogenesis, Exudation and Degeneration 2022 virtual conference held on February 11 and 12, researchers presented new 2-year data from Vabysmo YOSEMITE and RHINE studies of diabetic macular edema as well as Susvimo Archway study for wet (neovascular) age-related macular degeneration patients enrolled in these trials. Their findings provided evidence to extend time between treatments while still maintaining vision gains as observed with monthly standard-of-care injections.

Estimates suggest that up to 1.75 million Americans suffer from wet macular degeneration and could benefit from treatment with an ocular implant or monthly injections. While implants were associated with higher rates of endophthalmitis than injections, most cases were caused by conjunctival retraction or erosion which can be prevented with appropriate conjunctival management practices. Although not yet widely available, they should become widely accessible soon and will be covered by CareSource after prior authorization and documentation that shows improved or stabilized visual acuity within their medical record.

Lytenava

Retinal Vein Occlusion (RVO) is an eye condition that can result in permanent vision loss. It occurs when damaged blood vessels leak fluid into retinal tissue, leading to swelling and blurry vision. RVO is classified into two subcategories: central retinal vein occlusion (CRVO), which occurs due to blockage in one of the main retinal veins; and branch retinal vein occlusion (BRVO), caused by blocking off one of its smaller branches.

At present, there are three FDA-approved treatments for AMD: Lucentis (ranibizumab), Eylea (aflibercept) and Ozurdex (dexamethasone intravitreal implant). There are also promising therapies under development from Outlook Therapeutics, Kodiak Sciences, VivaVision Biotech Aerie Pharmaceuticals Taiwan Liposome which may prove useful.

LYTENAVA is an anti-VEGF monoclonal antibody (mAb), designed to block abnormal blood vessel growth. When administered as part of a treatment plan for wet macular degeneration (AMD), LYTENAVA has shown to significantly slow its progression – and potentially become standard treatment protocol for AMD patients.

Researchers recently conducted a study that demonstrated SD-OCT can accurately monitor progression of primary angle closure glaucoma (PACG). Results suggest GCC thinning as more reliable predictor than RNFL thinning for functional loss predictions in PACG patients. These findings support the idea that injections of Aflibercept can prevent progression to exudative AMD in high-risk patients, with its authors suggesting its use by physicians in these instances. Researchers cautioned that their findings do not imply that aflibercept is the sole therapeutic option available to high-risk patients at risk of exudative AMD. Instead, the authors recommend combination therapy using bevacizumab or ranibizumab rather than monotherapy alone as being more appropriate than either option alone.

Aflibercept

Aflibercept is being tested as an treatment option for wet age-related macular degeneration (AMD) and diabetic macular edema, two leading causes of vision loss. Aflibercept works by inhibiting vasoactive cytokines and other vascular endothelial growth factors that cause fluid leakage into the eye through intravitreal injection, providing effective reductions of retinal edema associated with neovascular AMD while being well tolerated; recent research demonstrated significant improvements in terms of best corrected visual acuity and thickness – supporting its use against both AMD and DME.

Submittal to the PBAC was based on two clinical trials, VIEW-1 and VIEW-2, designed to compare 2 mg aflibercept with 0.5 mg ranibizumab regarding maintenance of vision and number of treatments required. After reviewing these first year data from these trials, the PBAC determined they met primary efficacy endpoints of non-inferiority to laser therapy as well as maintenance of vision in patients with neovascular AMD with confidence levels greater than 95%.

Submittal also included a cost-utility analysis performed by Alimera. Their cost-utility analysis found that Aflibercept was more efficient and provided greater robust benefit of treatment than Ranibizumab and Bevacizumab for treating Neovascular AMD, making it the superior treatment option in treating Neovascular Age Related Macular Degeneration. Alimera will focus on expanding Aflibercept’s usage to treat more conditions; with availability anticipated by 2022 it will join their portfolio alongside ILUVIEN (fluocinolone intravitreal insert) 0.18mg used in DME treatments and Yutiq (fluocinolone Acetonide mono therapy; 0.19mg dose for chronic Non Infectious Uveitis).

Ranibizumab

New medications designed to treat neovascular age-related macular degeneration aim to curb abnormal blood vessel growth and leakage by acting as anti-angiogenics, which may slow vision loss while sometimes improving it. One such anti-angiogenic is ranibizumab (brand name Lucentis) injected every 4-6 weeks directly into the eye to treat wet forms of neovascular AMD.

Teva Pharmaceuticals’ biosimilar version of Ongavia drug has received approval by the UK Medicines and Healthcare Regulatory Agency as a treatment option, and will market the biosimilar under its brand name Ongavia. Teva anticipates that their version may be cheaper than its innovator product and help reduce overall healthcare costs for ophthalmic care.

According to the PBAC, ranibizumab has been found to lead to statistically significant improvements in best-corrected visual acuity (BCVA) and central macular thickness, and has also proven safe and effective during numerous clinical trials. As such, it has been listed on the Pharmaceutical Benefits Scheme as a treatment option for choroidal neovascularization associated with wet age-related macular degeneration, pathologic myopia, macular edema caused by retinal vein occlusion.

Susvimo, an FDA-approved implantable port-delivery system, is the first and only FDA-approved device for delivering continuous doses of ranibizumab to the eye. After being surgically placed during a brief procedure, refills will occur monthly through special injections; making it more convenient than intravitreal injections that require patients to visit a doctor’s office every month for treatment. Susvimo belongs to the VEGF inhibitor class of drugs.